TIMOTHY DURHAM (LISW-S) – Clinical Social Worker, NPI 1134644016

TIMOTHY DURHAM (LISW-S) is a healthcare provider. based in Granville, Ohio. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LISW-S. They hold a License No. I-000862-S (OH). The NPI Number for TIMOTHY DURHAM (LISW-S) is 1134644016

Main info

Male
29 Years Of Experience
Accepts Medicare Assignment
Name
TIMOTHY DURHAM (LISW-S)
NPI
1134644016
Phone
(740) 739-2903
Address
44 SHADY LN
Enumeration Date
11 August 2017
Last Update Date
11 August 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7405076707
Graduation Year
1997 (29 years ago)
PAC ID
7719384775
Group Practice PAC ID
9638235492
Professional Enrollment ID
I20210920000440
Address ID
OH430239560GR905XXAXXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:8State licenses:1Digital endpointsOther names

2,650 CLINICAL SOCIAL WORKER in OH

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Provider Addresses for TIMOTHY DURHAM (LISW-S)

  • Shady Lane, Granville Township, Licking County, Ohio, 43023, United States

    GRANVILLE, OH 430239281

    Phone: (740) 739-2903

    Type: Mailing

  • 905, River Road, Granville Township, Licking County, Ohio, 43023, United States

    GRANVILLE, OH 430239560

    Phone: (740) 507-6707

    Fax: (740) 739-2906

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-09-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210920000440IClinical Social WorkerOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour10812$0
View full utilization report →

Insurance plans in this area (ZIP 43023)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9638235492View full group profile
NameSpecialtyState
Clinical Social WorkerOH

Reviews

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Frequently asked questions

Can I cross-check TIMOTHY DURHAM (LISW-S) using NPI 1134644016?
NPI 1134644016 belongs to TIMOTHY DURHAM (LISW-S); compare other details if you need extra assurance.
Is TIMOTHY DURHAM (LISW-S) still an active registrant?
TIMOTHY DURHAM (LISW-S) carries an active NPI according to the public dataset.
What clinical focus is listed for TIMOTHY DURHAM (LISW-S)?
At a glance, TIMOTHY DURHAM (LISW-S) is tied to Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What practice footprint exists for TIMOTHY DURHAM (LISW-S)?
Travel planning: use Granville, Ohio as the reference point for TIMOTHY DURHAM (LISW-S), then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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