Active NPI
Thomas Tybeck, LMHC
- Professional Counselor
- Lecanto, FL
National Provider Identifier
1548418064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0701004432
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004945336 | Medicaid | VA |
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 |
|---|---|---|---|
| 0701004432 | VA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Multi-Specialty Clinic/Center
- Lecanto, FL
- NPI 1679036735
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.