TIM ENEVOLDSEN M.ED. LPC-S PLLC NPI 1184174609

NPI Information

NPI: 1184174609
Provider Name: TIM ENEVOLDSEN M.ED., LPC-S, PLLC
Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

Address:
6666 W AMARILLO BLVD
SUITE 4
AMARILLO, TX
ZIP 79106
Phone: (806) 570-3775
Get Directions

TIM ENEVOLDSEN M.ED., LPC-S, PLLC is a professional counselor in Amarillo, TX. TIM ENEVOLDSEN M.ED., LPC-S, PLLC NPI is 1184174609. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6666 W AMARILLO BLVD
SUITE 4
AMARILLO, TX
ZIP 79106-756
Phone: (806) 570-3775
Fax: (806) 358-3627

The provider's authorized official is Timothy John Enevoldsen .
The authorized official title is Therapist and has the following contact phone number (806) 570-3775.

The enumeration date for this NPI number is 10/7/2016 and was last updated on 10/7/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	10727	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	095362205	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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