Tim Enevoldsen M.Ed., Lpc-S, Pllc

LBN: Tim Enevoldsen M.Ed., Lpc-S, Pllc
Tim Enevoldsen M.Ed., Lpc-S, Pllc is an health care organization with primary practice located at 6666 W Amarillo Blvd Suite 4, Amarillo TX 79106-1756. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as the primary health care specialty. Tim Enevoldsen M.Ed., Lpc-S, Pllc can be contacted via phone (806) 570-3775, or through Enevoldsen, Timothy John via phone (806) 570-3775.

Contact Information

Primary practice address
6666 W Amarillo Blvd Suite 4 Amarillo TX 79106-1756
Phone: (806) 570-3775
Fax: (806) 358-3627
Website:
Map and Directions
Authorized official contact:
Name: Enevoldsen, Timothy John M.ED.,LPCS,LMFT,LCDC
Phone: (806) 570-3775

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 10727 Texas

Profile Details

NPI number 1184174609
LBN Legal business name Tim Enevoldsen M.Ed., Lpc-S, Pllc
DBA Doing business as
Authorized official Enevoldsen, Timothy John M.ED.,LPCS,LMFT,LCDC
Entity Organization
Organization subpart 1 No
Enumeration date Oct 7th, 2016
Last updated Oct 7th, 2016 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184174609 NPPES
Texas MEDICAID 095362205

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