Tim Allen Obert, MS, CPS, SAC, CCDS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

16363-131 Issued in WI

Practice address

1307 State Road 69
New Glarus, WI 53574-9328

Phone

(608) 527-2401

Fax

(608) 527-1939

NPI assigned

Nov 14, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• County of Green

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Monroe, WI
  • NPI 1992925085
  NPD (past)

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

{
    "created_epoch": "1510617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1396258240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2607 2ND AVE",
            "city": "MONROE",
            "state": "WI",
            "postal_code": "535663501",
            "telephone_number": "815-238-7891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 STATE ROAD 69",
            "city": "NEW GLARUS",
            "state": "WI",
            "postal_code": "535749328",
            "telephone_number": "608-527-2401",
            "fax_number": "608-527-1939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBERT",
        "first_name": "TIM",
        "middle_name": "ALLEN",
        "credential": "MS, CPS, SAC, CCDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-14",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16363-131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jana Meyers
• Brittany Mirsberger, BCBA
• Michelle Mussehl, RDH
• New Glarus Emergency Medical Service, Inc.
• New Glarus Home, Inc
• Christi Orozco
• Alivia Marie Palmer, BT
• Thomas D Pausma, D.M.D.
• Maureen Casey Priewe, OTR/L
• Gaines E Richardson, MD

• All providers in New Glarus, WI
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; 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.