Active NPI
Tasha Willaford
- Professional Counselor
- Columbus, OH
National Provider Identifier
1982134888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- E.1901470
- Practice address
- 444 Butterfly Gardens Dr
Columbus, OH 43215-3427 - Phone
- (614) 355-8080
- Fax
- (614) 355-4497
- NPI assigned
- Jun 14, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | M.1700044 | OH | |
| Professional Counselor | 101YP2500X | E.1901470 | OH | Primary |
Addresses
Primary practice location
444 Butterfly Gardens Dr
Columbus, OH 43215-3427
Mailing address
PO Box 78000
Detroit, MI 48278-1625
Phone (614) 355-8004
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1473276 | Medicaid | OH |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E.1901470 | OH | MD | Professional Counselor |
| M.1700044 | OH | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sondermind Provider Network LLC | Professional | Current | Accepting new patients |
Locations
3597 E Monarch Sky Ln
Ste 240
Meridian, ID 83646
Phone (208) 996-3519
20 S 3rd St
Ste 210
Columbus, OH 43215
Phone (614) 208-4973
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": "1497398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625616000000",
"number": "1982134888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 78000",
"city": "DETROIT",
"state": "MI",
"postal_code": "482781625",
"telephone_number": "614-355-8004",
"fax_number": "614-355-2220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "444 BUTTERFLY GARDENS DR",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432153427",
"telephone_number": "614-355-8080",
"fax_number": "614-355-4497"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLAFORD",
"first_name": "TASHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-14",
"last_updated": "2021-07-07",
"certification_date": "2021-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "OH",
"license": "M.1700044",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "E.1901470",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1473276",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.