Healthcare Provider Details

I. General information

NPI: 1578489456
Provider Name (Legal Business Name): TIM WALDEN MINISTRIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3129 BUTLER AVE SE
COVINGTON GA
30014-2854
US

IV. Provider business mailing address

3129 BUTLER AVE SE
COVINGTON GA
30014-2854
US

V. Phone/Fax

Practice location:
  • Phone: 404-790-1910
  • Fax: 470-200-2678
Mailing address:
  • Phone: 404-790-1910
  • Fax: 470-200-2678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES TIMOTHY WALDEN SR.
Title or Position: CRISIS COUNSELOR
Credential: CFCIS
Phone: 678-332-1504