Timothy Daniel Reynolds, M.A.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C3810 Issued in OR

Practice address

16535 SW Tualatin Valley Hwy
Beaverton, OR 97003

Phone

(503) 649-5651

Fax

(503) 649-7405

NPI assigned

May 14, 2015

Sex

Male

Sole proprietor

Yes

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

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2002

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Locations

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.

• Northwest Counseling Associates, LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Beaverton, OR
  • NPI 1922498914
  Medicare reassignment NPD
• St Mary'S Home for Boys

  • Counseling Psychologist
  • Beaverton, OR
  • NPI 1619057098

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533254400000",
    "number": "1518345131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16535 SW TUALATIN VALLEY HWY",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970035143",
            "telephone_number": "503-649-5651",
            "fax_number": "503-649-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16535 SW TUALATIN VALLEY HWY",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "97003",
            "telephone_number": "503-649-5651",
            "fax_number": "503-649-7405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 NE Stucki Ave Ste 150",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "971247108",
            "country_code": "US",
            "telephone_number": "503-444-8230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "TIMOTHY",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-14",
        "last_updated": "2018-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C3810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan V. Reyes-Torres, LMSW
• Julie M Reyes
• Jose L Reyna, DPT
• Sean Reynolds
• Susan Reynolds, MA MFT
• Robert Reynoso
• Melissa R. Rhines, L.M.T.
• Kenneth L Rhoads, M.D.
• Breanne Alisa-Dawn Rhodes, D.C.
• Sylvia Cristina Rhodes

• Mental Health Counselor in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.