Healthcare Provider Details

I. General information

NPI: 1659290120
Provider Name (Legal Business Name): TYLER GOINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4920 ROSWELL RD STE 1
SANDY SPRINGS GA
30342-2684
US

IV. Provider business mailing address

6655 SANTA BARBARA RD UNIT 8574
ELKRIDGE MD
21075-7523
US

V. Phone/Fax

Practice location:
  • Phone: 678-997-7249
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number33474
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberMSW010887
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: