Tim Fredrik E. Edquilag, LPC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC-17764 Issued in AZ

Practice address

18564 W Acacia Dr
Goodyear, AZ 85338-7889

Phone

(862) 345-7876

NPI assigned

Aug 13, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1439424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1881060804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18564 W ACACIA DR",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853387889",
            "telephone_number": "862-345-7876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18564 W ACACIA DR",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853387889",
            "telephone_number": "862-345-7876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDQUILAG",
        "first_name": "TIM FREDRIK",
        "middle_name": "E.",
        "name_prefix": "Mr.",
        "credential": "LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-13",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00527600",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-17764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Professional Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.