Healthcare Provider Details

I. General information

NPI: 1841121787
Provider Name (Legal Business Name): TIMOTHY DAVID DOAK MS, LCAT, FAMI, MTBC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 LANCER DR
NEWBURGH NY
12550-3823
US

IV. Provider business mailing address

4 LANCER DR
NEWBURGH NY
12550-3823
US

V. Phone/Fax

Practice location:
  • Phone: 518-307-6833
  • Fax:
Mailing address:
  • Phone: 518-307-6833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number002324
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number002324
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: