Active NPI
Tim A Phillips, PHD, ALA, ED.S, MS
- Counselor
- Gadsden, AL
National Provider Identifier
1841857026
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- C2864A
- Practice address
- 108 S 5TH St
Gadsden, AL 35901-4216 - Phone
- (256) 624-7099
- NPI assigned
- May 23, 2019
- Last updated
- May 23, 2019
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | C2864A | AL | Primary |
Addresses
Primary practice location
108 S 5TH St
Gadsden, AL 35901-4216
Mailing address
1003 Miss Annies Dr SW
Jacksonville, AL 36265-3023
Phone (256) 624-7099
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 Science, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C2864A | AL | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558569600000",
"number": "1841857026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1003 MISS ANNIES DR SW",
"city": "JACKSONVILLE",
"state": "AL",
"postal_code": "362653023",
"telephone_number": "256-624-7099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 S 5TH ST",
"city": "GADSDEN",
"state": "AL",
"postal_code": "359014216",
"telephone_number": "256-624-7099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "TIM",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PHD, ALA, ED.S, MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-05-23",
"last_updated": "2019-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "AL",
"license": "C2864A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gadsden, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.