Individual provider Active NPI

Kamala Kae Tahyi, LICDC; LPC

  • Professional Counselor
  • Zanesville, OH
National Provider Identifier
1760925457
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C.2203927 Issued in OH
Practice address
941 Blue Ave
Zanesville, OH 43701-4370
Phone
(740) 487-1768
NPI assigned
Nov 29, 2016
Last updated
Oct 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LICDC.131117 OH
Professional Counselor 101YP2500X C.2203927 OH Primary

Addresses

Primary practice location

941 Blue Ave
Zanesville, OH 43701-4370

Mailing address

941 Blue Ave
Zanesville, OH 43701
Phone (740) 487-1768

Other practice location 1

203 N Main St
New Lexington, OH 43764-1264
Phone (740) 342-1991 ext. 247

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20240510002721 OH Practitioner - Mental Health Counselor 4284075011 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Law

State licenses

LicenseStateTypeSpecialty
LICDC.131117OHMDAddiction (Substance Use Disorder) Counselor
C.2203927OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Life Support Therapy Services LLC Professional CurrentSince Apr 18, 2024 Accepting new patients

Locations

4035 Northpointe Dr
Unit B
Zanesville, OH 43701
Phone (740) 487-1768

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1480377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1760925457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "941 BLUE AVE",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "43701",
            "telephone_number": "740-487-1768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "941 BLUE AVE",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437014370",
            "telephone_number": "740-487-1768"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "203 N Main St",
            "address_purpose": "LOCATION",
            "city": "New Lexington",
            "state": "OH",
            "postal_code": "437641264",
            "country_code": "US",
            "telephone_number": "740-342-1991 x247",
            "fax_number": "740-342-2914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAHYI",
        "first_name": "KAMALA",
        "middle_name": "KAE",
        "credential": "LICDC; LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-29",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.131117",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.2203927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zanesville, OH

Sources for this page

Verify at the official NPI Registry.