Timothy J Daheim PA

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

31399 Issued in TX

Legal business name

TIMOTHY J DAHEIM PA

Practice address

2407 S Clear Creek Rd
Killeen, TX 76549-5721

Phone

(254) 773-0764

Fax

(254) 935-2258

NPI assigned

Nov 12, 2013

Organization subpart

No

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

Authorized official

Name

Timothy J Daheim, PHDNPI 1437176955

Title

Owner

Phone

(254) 773-0764

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Timothy Joseph Daheim, PHD

  • Psychologist
  • Killeen, TX
  • NPI 1437176955
  Medicare reassignment NPD Authorized official
• Amy O'Neill Adcock, PH.D.

  • Psychologist
  • Temple, TX
  • NPI 1346420536
  NPD (past)
• Melissia Elaine Beckham, LCSW

  • Clinical Social Worker
  • Killeen, TX
  • NPI 1245470277
  NPD (past)
• Ty Lowell Tulloch, LPC, LSOTP

  • Counselor
  • Temple, TX
  • NPI 1184630063
  NPD (past)
• Laura Mueller-Anderson, LICSW

  • Clinical Social Worker
  • Marshall, MN
  • NPI 1801211099
  NPD (past)

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

{
    "created_epoch": "1384214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487030400000",
    "number": "1376973321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 204",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765030204",
            "telephone_number": "254-773-0764",
            "fax_number": "254-935-2258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2407 S CLEAR CREEK RD",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765495721",
            "telephone_number": "254-773-0764",
            "fax_number": "254-935-2258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY J DAHEIM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-12",
        "last_updated": "2017-02-14",
        "status": "A",
        "authorized_official_last_name": "DAHEIM",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "254-773-0764",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "TX",
            "license": "31399",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "31399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "347534501",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140806403",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Memorie T Tiapula, APRN
• Kyla Chiann Tillman
• Lillian Jessica Tillotson
• La'Porsha Dejone' Timmons
• Melissa Timmons, PMHNP BC
• Amanda Michelle Tindell, LCSW
• Emma Tindell
• Kristin Leigh Tindell, BCBA
• Donald R Tolbert, CRNA
• Monica Leticia Tolbert, MC, MBH, LPC

• Clinical Psychologist in Killeen, TX
• Providers in Killeen, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.