Active NPI
Ronald Lee Timmcke, M.A
- Mental Health Counselor
- Albuquerque, NM
National Provider Identifier
1760702740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 2741
- Practice address
- 4253 Montgomery Blvd NE
Suite 220
Albuquerque, NM 87109-1106 - Phone
- (505) 342-0400
- Fax
- (505) 342-0500
- NPI assigned
- Jun 1, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 3907 | NM | |
| Mental Health Counselor | 101YM0800X | 2741 | NM | Primary |
Addresses
Primary practice location
4253 Montgomery Blvd NE
Suite 220
Albuquerque, NM 87109-1106
Mailing address
13204 Silver Peak PL NE
Albuquerque, NM 87111-8261
Phone (505) 850-7301
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Z4928 | Medicaid | NM | |
| 000189347 | Other | NM | OPTUM HEALTH NEW MEXICO |
| 1054648 | Other | NM | CIGNA BEHAVIORAL HEALTH INC. |
| 43728 | Other | NM | PRESBYTERIAN |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3907 | NM | MD | Addiction (Substance Use Disorder) Counselor |
| 2741 | NM | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379894400000",
"number": "1760702740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13204 SILVER PEAK PL NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871118261",
"telephone_number": "505-850-7301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4253 MONTGOMERY BLVD NE",
"address_2": "SUITE 220",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871091106",
"telephone_number": "505-342-0400",
"fax_number": "505-342-0500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIMMCKE",
"first_name": "RONALD",
"middle_name": "LEE",
"name_prefix": "Mr.",
"credential": "M.A",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-06-01",
"last_updated": "2013-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NM",
"license": "3907",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NM",
"license": "2741",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Z4928",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTUM HEALTH NEW MEXICO",
"identifier": "000189347",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA BEHAVIORAL HEALTH INC.",
"identifier": "1054648",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRESBYTERIAN",
"identifier": "43728",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.