Healthcare Provider Details

I. General information

NPI: 1780350165
Provider Name (Legal Business Name): TIMMONS COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2021
Last Update Date: 09/09/2026
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16717 PROMENADE ST
BROOMFIELD CO
80023
US

IV. Provider business mailing address

16717 PROMENADE ST
BROOMFIELD CO
80023
US

V. Phone/Fax

Practice location:
  • Phone: 978-595-2019
  • Fax:
Mailing address:
  • Phone: 978-595-2019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: CODY S TIMMONS
Title or Position: OWNER
Credential: LMHC
Phone: 978-595-2019