TIMOTHY PAUL LANDRY (LCSW) – Mental Health Counselor, NPI 1700340270

TIMOTHY PAUL LANDRY (LCSW) is a healthcare provider. based in Cottage grove, Oregon. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. L6526 (OR). The NPI Number for TIMOTHY PAUL LANDRY (LCSW) is 1700340270

Main info

Male
Sole Proprietor
11 Years Of Experience
Accepts Medicare Assignment
Name
TIMOTHY PAUL LANDRY (LCSW)
NPI
1700340270
Phone
(503) 347-0003
Address
PO BOX 291
Enumeration Date
29 January 2019
Last Update Date
5 March 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5417675200
Graduation Year
2015 (11 years ago)
PAC ID
3274967674
Group Practice PAC ID
9436060530
Professional Enrollment ID
I20191217002915
Address ID
OR974249700CO1515XDRXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:7State licenses:1Digital endpointsOther names

1,405 CLINICAL SOCIAL WORKER in OR

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Provider Addresses for TIMOTHY PAUL LANDRY (LCSW)

  • 291, Cottage Walk, Ocean Beach, Suffolk County, New York, 11770, United States

    COTTAGE GROVE, OR 974240010

    Phone: (503) 347-0003

    Type: Mailing

  • 1450, Birch Avenue, Cottage Grove, Lane County, Oregon, 97424, United States

    COTTAGE GROVE, OR 974241417

    Phone: (503) 347-0003

    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: 2019-12-17

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
I20191217002915IClinical Social WorkerORTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97424)

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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: 9436060530View full group profile

Reviews

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Frequently asked questions

What is TIMOTHY PAUL LANDRY (LCSW)'s NPI number?
TIMOTHY PAUL LANDRY (LCSW)'s NPI is 1700340270 — the number used across U.S. healthcare to identify this provider.
Active or inactive — what applies to TIMOTHY PAUL LANDRY (LCSW)?
You should see TIMOTHY PAUL LANDRY (LCSW) as active in CMS-hosted NPPES data.
What area of care is associated with TIMOTHY PAUL LANDRY (LCSW)?
TIMOTHY PAUL LANDRY (LCSW)'s record emphasizes Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Is TIMOTHY PAUL LANDRY (LCSW) located near Cottage Grove?
TIMOTHY PAUL LANDRY (LCSW) currently maps to Cottage Grove, Oregon in this extract.
Does TIMOTHY PAUL LANDRY (LCSW) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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