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General NPI Number Information
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NPI Number | 1225339351
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Entity Type | Individual
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Provider Name | TIMOTHY ALAN PLATT LPC
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Gender | Male
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Dates
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Enumeration Date | 11/05/2010
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Last Update Date | 11/22/2017
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Provider Practice Location Address
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Address Line | 333 W WILCOX DR STE 202
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-1790
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Country | US
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Telephone | 520-867-5889
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Fax |
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Provider Business Mailing Address
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Address Line | 7060 E SAHUARITA RD
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City | SAHUARITA
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State | AZ
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Zip | 85629-9391
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Country | US
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Telephone | 520-867-5889
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 67105
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 16756
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License Number State | AZ
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