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General NPI Number Information
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NPI Number | 1811666167
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Entity Type | Individual
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Provider Name | TIMOTHY JAMES HEWITT MPS, LPCC, LADC
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Gender | Male
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Dates
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Enumeration Date | 09/09/2021
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 3033 EXCELSIOR BLVD
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City | MINNEAPOLIS
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State | MN
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Zip | 55416-4688
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Country | US
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Telephone | 612-460-0485
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Fax |
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Provider Business Mailing Address
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Address Line | 2123 BAY DR
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City | LINO LAKES
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State | MN
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Zip | 55038-4690
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Country | US
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Telephone | 231-330-4975
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 306056
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 4663
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License Number State | MN
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