Wysocki, Timothy T.

Wysocki, Timothy T. is an individual health care provider with primary practice located at 807 Childrens Way , Jacksonville FL 32207-8426. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Clinical Child & Adolescent is his primary health care specialty. Wysocki, Timothy T. can be contacted via phone (904) 390-3785.

Contact Information

Primary practice address
807 Childrens Way Jacksonville FL 32207-8426
Phone: (904) 390-3785
Fax: (904) 390-3512
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PY4811 Florida
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X PY4811 Florida

Profile Details

NPI number 1205847738
LBN Legal business name Wysocki, Timothy T.
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 10th, 2006
Last updated Sep 2nd, 2011 - about 14 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1205847738 NPPES
Georgia MEDICAID 000546202A

Popular Providers