Individual provider Active NPI

Timothy Michael Luis, PH.D.

  • Mental Health Counselor
  • Powell, OH
National Provider Identifier
1881907129
Registry record updated Oct 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6721 Issued in OH
Practice address
35 W Olentangy St
Powell, OH 43065-8717
Phone
(614) 436-4457
NPI assigned
Jul 15, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6721 OH Primary

Addresses

Primary practice location

35 W Olentangy St
Powell, OH 43065-8717

Mailing address

35 West Olentangy Street
Powell, OH 43065
Phone (614) 436-4457

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
I20180111000404 OH Practitioner - Clinical Psychologist 8426324260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orleans Psychological ServicesGroup PAC ID 7517233356, 3 clinicians

Practice addresses (Care Compare)

35 W Olentangy St
Powell, OH 43065-8717
Phone (614) 436-4457

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Orleans Psychological Services Mental Health CurrentSince Oct 2, 2017 Accepting new patients

Locations

35 W Olentangy St
Powell, OH 43065
Phone (614) 436-4457

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508889600000",
    "number": "1881907129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 WEST OLENTANGY STREET",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "43065",
            "telephone_number": "614-436-4457",
            "fax_number": "614-407-9648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 W OLENTANGY ST",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "430658717",
            "telephone_number": "614-436-4457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUIS",
        "first_name": "TIMOTHY",
        "middle_name": "MICHAEL",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-15",
        "last_updated": "2017-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "6721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Powell, OH

Sources for this page

Verify at the official NPI Registry.