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General NPI Number Information
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NPI Number | 1629597364
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Entity Type | Individual
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Provider Name | TIMOTHY WALTER FLAHARTY LPCC
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Gender | Male
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Dates
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Enumeration Date | 09/13/2017
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Last Update Date | 07/10/2020
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Provider Practice Location Address
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Address Line | 1110 E CHAPMAN AVE STE 203
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City | ORANGE
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State | CA
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Zip | 92866-2139
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Country | US
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Telephone | 443-910-1262
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Fax |
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Provider Business Mailing Address
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Address Line | 5332 CALIENTE DR
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92649-2618
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Country | US
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Telephone |
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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 | 7896
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License Number State | CA
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