Individual provider Active NPI

Timothy P. Dailey, LPC

  • Professional Counselor
  • Clyde, NC
National Provider Identifier
1104951763
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2919 Issued in NC
Practice address
111 Sneed Dr
Clyde, NC 28721-8468
Phone
(828) 627-9254
Fax
(828) 627-8811
NPI assigned
Feb 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2919 NC
Professional Counselor 101YP2500X 2919 NC Primary

Addresses

Primary practice location

111 Sneed Dr
Clyde, NC 28721-8468

Mailing address

PO Box 338
204 Idol Drive
Thomasville, NC 27361-0338
Phone (336) 474-1276

Other identifiers 1

IdentifierTypeStateIssuer
6102842MedicaidNC

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Children'S Homes of North Carolina Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1104951763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 338",
            "address_2": "204 IDOL DRIVE",
            "city": "THOMASVILLE",
            "state": "NC",
            "postal_code": "273610338",
            "telephone_number": "336-474-1276",
            "fax_number": "336-472-4605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SNEED DR",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287218468",
            "telephone_number": "828-627-9254",
            "fax_number": "828-627-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAILEY",
        "first_name": "TIMOTHY",
        "middle_name": "P.",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "2919",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "2919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102842",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clyde, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.