Active NPI
Timothy L Wells, LPC
- Professional Counselor
- Nevada, MO
National Provider Identifier
1033293204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 002368CS
- Practice address
- 200 S Alma St
Nevada, MO 64772-3945 - Phone
- (417) 667-9697
- Fax
- (417) 667-5737
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 002368CS | MO | Primary |
Addresses
Primary practice location
200 S Alma St
Nevada, MO 64772-3945
Mailing address
904 W Hunter St
Nevada, MO 64772-2032
Phone (417) 667-9697
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 25896032 | Other | MO | BCBS OF KANSAS CITY |
| 499675825 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002368CS | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1033293204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "904 W HUNTER ST",
"city": "NEVADA",
"state": "MO",
"postal_code": "647722032",
"telephone_number": "417-667-9697",
"fax_number": "417-667-5737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 S ALMA ST",
"city": "NEVADA",
"state": "MO",
"postal_code": "647723945",
"telephone_number": "417-667-9697",
"fax_number": "417-667-5737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "TIMOTHY",
"middle_name": "L",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "002368CS",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF KANSAS CITY",
"identifier": "25896032",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "499675825",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nevada, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.