Active NPI
Timothy Alle Griswold
- Mental Health Counselor
- Covington, WA
National Provider Identifier
1073260410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 27121 174TH PL SE Ste 101
Covington, WA 98042-4939 - Phone
- (253) 867-4495
- Fax
- (253) 867-8756
- NPI assigned
- Mar 6, 2022
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
27121 174TH PL SE Ste 101
Covington, WA 98042-4939
Mailing address
27121 174TH PL SE Ste 101
Covington, WA 98042-4939
Phone (253) 867-4495
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Aug 2, 2024 through Aug 2, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730073600000",
"number": "1073260410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27121 174TH PL SE STE 101",
"city": "COVINGTON",
"state": "WA",
"postal_code": "980424939",
"telephone_number": "253-867-4495",
"fax_number": "253-867-8756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27121 174TH PL SE STE 101",
"city": "COVINGTON",
"state": "WA",
"postal_code": "980424939",
"telephone_number": "253-867-4495",
"fax_number": "253-867-8756"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRISWOLD",
"first_name": "TIMOTHY",
"middle_name": "ALLE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-03-06",
"last_updated": "2024-10-28",
"certification_date": "2024-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covington, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.