Healthcare Provider Details

I. General information

NPI: 1003759267
Provider Name (Legal Business Name): TYLER ARTHUR BRAHM LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16-24 UNION STREET CLINIC
MIDDLETOWN NY
10940
US

IV. Provider business mailing address

4 GALLOPING HILL RD
MONTAGUE NJ
07827-3204
US

V. Phone/Fax

Practice location:
  • Phone: 973-670-3911
  • Fax:
Mailing address:
  • Phone: 973-670-3911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number130838
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: