Individual provider Active NPI

Ashley Timberlake, LPC

  • Addiction (Substance Use Disorder) Counselor
  • Columbus, OH
National Provider Identifier
1861996530
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
C.1801063 Issued in OH
Practice address
455 E Mound St
Columbus, OH 43215-5595
Phone
(614) 242-1284
Fax
(614) 242-1285
NPI assigned
Mar 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C.1801063 OH
Addiction (Substance Use Disorder) Counselor 101YA0400X C.1801063 OH Primary

Addresses

Primary practice location

455 E Mound St
Columbus, OH 43215-5595

Mailing address

455 E Mound St
Columbus, OH 43215-5595
Phone (614) 242-1284

Other practice location 1

4995 Bradenton Ave Ste 130
Dublin, OH 43017-3551
Phone (614) 580-6917

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
I20240205000051 OH Practitioner - Mental Health Counselor 4082057336 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oh Independent Medical Group LLCGroup PAC ID 0648646034, 136 clinicians
Concord Psychiatry, LLCGroup PAC ID 3577884105, 37 clinicians

Practice addresses (Care Compare)

4995 Bradenton Ave
Suite 130
Dublin, OH 43017-3551
Phone (614) 580-6917

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Oh Independent Medical Group LLC CurrentSince Mar 31, 2026 Accepting new patients
Oh Independent Medical Group LLC CurrentSince Mar 31, 2026 Accepting new patients

Locations

4995 Bradenton Ave
Ste 130
Dublin, OH 43017
Phone (614) 580-6917

Organizations & group practices 3

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": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1861996530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 E MOUND ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432155595",
            "telephone_number": "614-242-1284",
            "fax_number": "614-242-1285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 E MOUND ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432155595",
            "telephone_number": "614-242-1284",
            "fax_number": "614-242-1285"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4995 Bradenton Ave Ste 130",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "OH",
            "postal_code": "430173551",
            "country_code": "US",
            "telephone_number": "614-580-6917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIMBERLAKE",
        "first_name": "ASHLEY",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-19",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.1801063",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "C.1801063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.