Timothy G Calvin, PSYD, CAADC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS017320 Issued in PA

Practice address

1170 S State St
Ephrata, PA 17522-2601

Phone

(717) 859-8000

NPI assigned

Sep 29, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Total Life IncGroup PAC ID 8123433034, 113 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Total Life Inc.

  • Group Psychotherapy Psychologist
  • Jupiter, FL
  • NPI 1053909267

  PA

  Medicare reassignment Care Compare group NPD
• Total Life FL PA

  dba Total Life

  • Integrative Medicine Physician
  • Potomac, MD
  • NPI 1447057286

  Clinical, PA

  Medicare reassignment NPD

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

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1215261961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 S STATE ST",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175222601",
            "telephone_number": "717-859-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 S STATE ST",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175222601",
            "telephone_number": "717-859-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "938 Penn St",
            "address_purpose": "LOCATION",
            "city": "Reading",
            "state": "PA",
            "postal_code": "196021717",
            "country_code": "US",
            "telephone_number": "610-478-8088",
            "fax_number": "610-478-4884",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Eagleville Rd",
            "address_purpose": "LOCATION",
            "city": "Eagleville",
            "state": "PA",
            "postal_code": "194031829",
            "country_code": "US",
            "telephone_number": "610-635-7594",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALVIN",
        "first_name": "TIMOTHY",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "PSYD, CAADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-29",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS017320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Burton, BA
• By Your Side Counseling (Kristina Dundore)
• Ann Marie Bybel, M.D.
• Natalie Byler, COTA/L
• Bernadette Cafoncelli, BA, CDAC
• Edward Gabriel Camerino, M.D.
• Eugene Lee Camerino, D.O.
• Cary L Campanella, MD
• Huyen Van Cao, M.D,
• Rebecca Lynne Capitao, OTR/L

• Clinical Psychologist in Ephrata, PA
• Providers in Ephrata, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.