Individual provider Active NPI

Thomas Tybeck, LMHC

  • Professional Counselor
  • Lecanto, FL
National Provider Identifier
1548418064
Registry record updated Aug 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701004432 Issued in VA
Practice address
324 S Kensington Ave Ste 328
Lecanto, FL 34461
Phone
(352) 422-1668
NPI assigned
Sep 9, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701004432 VA Primary

Addresses

Primary practice location

324 S Kensington Ave Ste 328
Lecanto, FL 34461

Mailing address

5880 N Tsala Apopka Dr
Hernando, FL 34442-7900
Phone (352) 422-1668

Other practice location 1

85 Sangers Ln
Staunton, VA 24401-6712
Phone (540) 887-3200

Other identifiers 1

IdentifierTypeStateIssuer
004945336MedicaidVA

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
0701004432VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Goodpeace Solutions, 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1548418064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5880 N TSALA APOPKA DR",
            "city": "HERNANDO",
            "state": "FL",
            "postal_code": "344427900",
            "telephone_number": "352-422-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 S KENSINGTON AVE STE 328",
            "city": "LECANTO",
            "state": "FL",
            "postal_code": "34461",
            "telephone_number": "352-422-1668"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "85 Sangers Ln",
            "address_purpose": "LOCATION",
            "city": "Staunton",
            "state": "VA",
            "postal_code": "244016712",
            "country_code": "US",
            "telephone_number": "540-887-3200",
            "fax_number": "540-887-3240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TYBECK",
        "first_name": "THOMAS",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-09",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701004432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004945336",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lecanto, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2018; 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.