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NPI Code Detail

MEDICARE: TIMOTHY C MCNAMARA MA, LP

MEDICARE: TIMOTHY C MCNAMARA MA, LP
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
1103TC0700XClinical PsychologistLP1540MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2411425197OTHERMNCIGNA BEHAVIORAL HEALTH
3HP19964OTHERMNHEALTHPARTNERS
4101898C154OTHERMNUCARE
5302928OTHERMNUSA NETWORK
66220003OTHERMNMEDICA CHOICE
77H905MCOTHERMNBCBS

General Provider Information

NPI Number : 1346317781
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY C MCNAMARA MA, LP
Provider Business Mailing Address
First Line : 4240 PARK GLEN RD
Second Line :
City : ST LOUIS PARK
State : MN
Zip : 55416-5427
Country : US
Telephone Number : 612-925-6033
Fax Number : 612-925-8496
Provider Business Practice Location Address
First Line : 4027 COUNTY ROAD 25
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55416-2629
Country : US
Telephone Number : 612-925-6033
Fax Number : 612-925-8496
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2006
Last Update Date : 10/23/2023

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Directions to “ TIMOTHY C MCNAMARA MA, LP” Practice Location

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