Healthcare Provider Details

I. General information

NPI: 1144926692
Provider Name (Legal Business Name): TIMOTHY G AYD LGPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2023
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 TOWNE HOUSE RD
HAMDEN CT
06514-2137
US

IV. Provider business mailing address

2389 MAIN ST STE 100
GLASTONBURY CT
06033-4617
US

V. Phone/Fax

Practice location:
  • Phone: 443-372-8169
  • Fax:
Mailing address:
  • Phone: 443-910-2831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC16214
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: