Active NPI
Liudmila Petrovna Timm, LPCC
- Professional Counselor
- Saint Paul, MN
National Provider Identifier
1053487892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- CC00698
- Practice address
- 499 Wacouta St
Saint Paul, MN 55101-2355 - Phone
- (651) 528-9410
- NPI assigned
- Nov 24, 2006
- Sex
- Female
- Sole proprietor
- No
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 | CC00698 | MN | Primary |
Addresses
Primary practice location
499 Wacouta St
Saint Paul, MN 55101-2355
Mailing address
8626 W Bush Lake Rd
Bloomington, MN 55438-1321
Phone (952) 941-5217
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 |
|---|---|---|---|
| CC00698 | MN | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390176000000",
"number": "1053487892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8626 W BUSH LAKE RD",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554381321",
"telephone_number": "952-941-5217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "499 WACOUTA ST",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551012355",
"telephone_number": "651-528-9410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIMM",
"first_name": "LIUDMILA",
"middle_name": "PETROVNA",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-24",
"last_updated": "2014-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MN",
"license": "CC00698",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.