Individual provider Active NPI

Tasha Willaford

  • Professional Counselor
  • Columbus, OH
National Provider Identifier
1982134888
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.1901470 Issued in OH
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

Updated by the provider on Jul 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1473276MedicaidOH

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
I20240325000404 OH Practitioner - Mental Health Counselor 7113364332 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E.1901470OHMDProfessional Counselor
M.1700044OHMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Professional CurrentSince Mar 4, 2024 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

Verify at the official NPI Registry.