Enevoldsen, Timothy John

Enevoldsen, Timothy John is an sole proprietor health care provider with primary practice located at 6666 W Amarillo Blvd Suite 28, Amarillo TX 79106-1756. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Enevoldsen, Timothy John can be contacted via phone (806) 570-3775.

Contact Information

Primary practice address
6666 W Amarillo Blvd Suite 28 Amarillo TX 79106-1756
Phone: (806) 570-3775
Fax: (806) 356-8189
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 10727 Texas
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 003822-042155 Texas

Profile Details

NPI number 1851404206
LBN Legal business name Enevoldsen, Timothy John
Credentials M.ED., LPC, LMFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 17th, 2006
Last updated Jun 17th, 2008 - about 18 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 1851404206 NPPES
Texas MEDICAID 095362201

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