Provider Demographics
NPI:1255584934
Name:TYBERG, YONI (LCSW-C, LICSW)
Entity type:Individual
Prefix:MR
First Name:YONI
Middle Name:
Last Name:TYBERG
Suffix:
Gender:M
Credentials:LCSW-C, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11519 LOCKHART PL
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-3166
Mailing Address - Country:US
Mailing Address - Phone:301-325-5718
Mailing Address - Fax:
Practice Address - Street 1:11249 LOCKWOOD DR
Practice Address - Street 2:SUITE C
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-4563
Practice Address - Country:US
Practice Address - Phone:301-576-5293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD145441041C0700X
DCLC500785971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical