Doctor Name: | PHILIP JAMES TIMS |
NPI Number: | 1659594398 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MA LLPC |
License Number: | 6401009058 |
Business Practice Address: | 2 Crocker Blvd Suite 101 Mt Clemens, MI - 480432558 |
Business Phone Number: | 5864682266 |
Business Fax Number: | 5864684505 |
Mailing Address: | 54835 Marissa Way, SHELBY TOWNSHIP |
State: | MI |
Postal Code: | 483165619 |
Phone Number: | 5863066218 |
Fax Number: | |
NPI Enumeration Date: | 04/11/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 6401009058 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |