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NPI Code Detail

MEDICARE: TIMSON JOHN LATIMER L.M.H.C., L.A.D.C.

MEDICARE: TIMSON JOHN LATIMER L.M.H.C., L.A.D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor1111MA
2101YM0800XMental Health Counselor5388MA

General Provider Information

NPI Number : 1205915949
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMSON JOHN LATIMER L.M.H.C., L.A.D.C.
Provider Business Mailing Address
First Line : 16 FULLER DR
Second Line :
City : PLYMOUTH
State : MA
Zip : 02360-1214
Country : US
Telephone Number : 508-224-5197
Fax Number :
Provider Business Practice Location Address
First Line : 94 S MAIN ST
Second Line :
City : MIDDLEBORO
State : MA
Zip : 02346-2123
Country : US
Telephone Number : 508-947-6100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2006
Last Update Date : 03/07/2008

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