Individual provider Active NPI

Tim Harless

  • Counselor
  • Moore, OK
National Provider Identifier
1639818222
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
501 SE 4TH St Ste C
Moore, OK 73160-6831
Phone
(405) 693-1159
NPI assigned
Jun 1, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

501 SE 4TH St Ste C
Moore, OK 73160-6831

Mailing address

501 SE 4TH St Ste C
Moore, OK 73160-6831
Phone (405) 693-1159

Other names 1

  • Jillian Chelini Professional name

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
Lynch Family Services LLC CurrentSince Jun 5, 2022 Accepting new patients
Premiere Pediatrics PLLC Past Accepting new patients

Locations

333 W Main St
Ste 140
Ardmore, OK 73401
Phone (580) 224-2929

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1639818222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 SE 4TH ST STE C",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731606831",
            "telephone_number": "405-693-1159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SE 4TH ST STE C",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731606831",
            "telephone_number": "405-693-1159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARLESS",
        "first_name": "TIM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-01",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILLIAN",
            "last_name": "CHELINI",
            "credential": "LMFT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Moore, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; 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.