Active NPI
Timothy Joseph Zoebelein, LCSW
- Mental Health Counselor
- Forest Grove, OR
National Provider Identifier
1780865568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 1723
- Practice address
- 1609 Elm St
Forest Grove, OR 97116-2503 - Phone
- (503) 357-8793
- NPI assigned
- Nov 20, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 1723 | OR | Primary |
Addresses
Primary practice location
1609 Elm St
Forest Grove, OR 97116-2503
Mailing address
PO Box 855
Forest Grove, OR 97116-0855
Phone (503) 357-8793
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120201000927 | OR | Practitioner - Clinical Social Worker | 3971760034 | Practice locations: Forest Grove, OR |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1516 Rodlun CT
Forest Grove, OR 97116-1368
1904 Elm St
Suite 5
Forest Grove, OR 97116-2553
Phone (503) 357-8793
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1723 | OR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195516800000",
"number": "1780865568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 855",
"city": "FOREST GROVE",
"state": "OR",
"postal_code": "971160855",
"telephone_number": "503-357-8793"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1609 ELM ST",
"city": "FOREST GROVE",
"state": "OR",
"postal_code": "971162503",
"telephone_number": "503-357-8793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZOEBELEIN",
"first_name": "TIMOTHY",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-11-20",
"last_updated": "2007-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "1723",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Grove, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.