Active NPI
Dave Timmerman, PCC, CRC
- Mental Health Counselor
- Toledo, OH
National Provider Identifier
1437465374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- E0500076
- Practice address
- 2809 Algonquin Pkwy
Toledo, OH 43606-3713 - Phone
- (419) 475-2300
- NPI assigned
- Aug 30, 2010
- 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 | E0500076 | OH | Primary |
Addresses
Primary practice location
2809 Algonquin Pkwy
Toledo, OH 43606-3713
Mailing address
2809 Algonquin Pkwy
Toledo, OH 43606-3713
Phone (419) 475-2300
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E0500076 | OH | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283126400000",
"number": "1437465374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2809 ALGONQUIN PKWY",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436063713",
"telephone_number": "419-475-2300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2809 ALGONQUIN PKWY",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436063713",
"telephone_number": "419-475-2300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIMMERMAN",
"first_name": "DAVE",
"name_prefix": "Mr.",
"credential": "PCC, CRC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-08-30",
"last_updated": "2010-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "E0500076",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.