Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tyran Dewalt

Individual provider Clinical Social Worker · NPI 1720366933

Tyran Dewalt is a Clinical Social Worker in Louisville, Kentucky. Licensed in Kentucky. Registered with an NPI since 2011.

Licensed in
KY
In the registry since
2011

Practice location Address checks out

10510 La Grange Rd
Louisville, KY 40223-1277
Phone: (502) 589-8600
Fax: (502) 589-8771
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 260261 (KY)

Record details

NPI number1720366933
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 22, 2011
Last updated in NPPESDecember 1, 2025
Certification dateDecember 1, 2025

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