Individual provider Active NPI

Timothy Paul Lewis

  • Mental Health Counselor
  • Puyallup, WA
National Provider Identifier
1891222774
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MHCAMC60323305 Issued in WA
Practice address
401 15TH Ave SE
Puyallup, WA 98372-3715
Phone
(253) 686-8335
NPI assigned
May 22, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 MHCAMC60323305 WA Primary

Addresses

Primary practice location

401 15TH Ave SE
Puyallup, WA 98372-3715

Mailing address

5414 Marian Dr NE
Olympia, WA 98516-2247
Phone (253) 686-8335

Other practice location 1

413 Lilly Rd NE
Olympia, WA 98506-5133
Phone (253) 686-8335

Other practice location 2

525 Lilly Rd NE Fl 1
Olympia, WA 98506-5101
Phone (253) 686-8335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20240627003630 WA Practitioner - Mental Health Counselor 5799229035 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MHCAMC60323305WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince May 13, 2024 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince May 13, 2024 Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

413 Lilly Rd NE
Olympia, WA 98506
Phone (360) 491-9480

401 15th Ave SE
Puyallup, WA 98372
Phone (253) 697-1848

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": "1495411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1891222774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5414 MARIAN DR NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985162247",
            "telephone_number": "253-686-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 15TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723715",
            "telephone_number": "253-686-8335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "413 Lilly Rd NE",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985065133",
            "country_code": "US",
            "telephone_number": "253-686-8335",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "525 Lilly Rd NE Fl 1",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985065101",
            "country_code": "US",
            "telephone_number": "253-686-8335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "TIMOTHY",
        "middle_name": "PAUL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-22",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MHCAMC60323305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.