Cammack, Timothy Lee

Cammack, Timothy Lee is an individual health care provider with primary practice located at 3915 Golden Valley Road Courage Center, Golden Valley MN 55422-4298. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Cammack, Timothy Lee can be contacted via phone (763) 520-0645.

Contact Information

Primary practice address
3915 Golden Valley Road Courage Center Golden Valley MN 55422-4298
Phone: (763) 520-0645
Fax: (763) 520-0355
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 06687 Minnesota

Profile Details

NPI number 1972554111
LBN Legal business name Cammack, Timothy Lee
Credentials LICSW
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972554111 NPPES
Other 963371012571 PREFERRED ONE
Other 89D34CA PREFERRED ONE
Other 6236582 PREFERRED ONE
Other 6236582 PREFERRED ONE
Other HP23150 PREFERRED ONE

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