NPIMap

Individual provider Active NPI

Timilla Barksdale

  • Counselor
  • Gary, IN
National Provider Identifier
1467896555
Registry record updated Apr 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
1601 Broadway
Gary, IN 46407-2239
Phone
(219) 628-3721
Fax
(219) 882-0210
NPI assigned
Apr 19, 2013
Last updated
Apr 19, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Professional Counselor 101YP2500X
Behavior Analyst 103K00000X

Addresses

Primary practice location

1601 Broadway
Gary, IN 46407-2239

Mailing address

1601 Broadway
Gary, IN 46407-2239
Phone (219) 628-3721

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
Timilla's Mentoring Center Past Accepting new patients
Adonia Coummunity Services Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1366329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366329600000",
    "number": "1467896555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 BROADWAY",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464072239",
            "telephone_number": "219-628-3721",
            "fax_number": "219-882-0210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 BROADWAY",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464072239",
            "telephone_number": "219-628-3721",
            "fax_number": "219-882-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARKSDALE",
        "first_name": "TIMILLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-19",
        "last_updated": "2013-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gary, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2013; 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.