Individual provider Active NPI

Marcilla D Tims, LMFT

  • Marriage & Family Therapist
  • Denver, CO
National Provider Identifier
1477713568
Registry record updated Mar 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
690 Issued in CO
Practice address
2539 Eliot St
Denver, CO 80211-4709
Phone
(303) 455-3767
NPI assigned
Jun 11, 2008
Last updated
Mar 28, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 690 CO Primary

Addresses

Primary practice location

2539 Eliot St
Denver, CO 80211-4709

Mailing address

2539 Eliot St
Denver, CO 80211-4709
Phone (303) 455-3767

Other identifiers 1

IdentifierTypeStateIssuer
72632771MedicaidCO

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

LicenseStateTypeSpecialty
690COMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Flourish Counseling, LLC Past Accepting new patients

Organizations & group practices 1

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": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395964800000",
    "number": "1477713568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2539 ELIOT ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802114709",
            "telephone_number": "303-455-3767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2539 ELIOT ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802114709",
            "telephone_number": "303-455-3767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMS",
        "first_name": "MARCILLA",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2014-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CO",
            "license": "690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "72632771",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2014; 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.