Provider Demographics
NPI:1215362520
Name:BANDELL, TIMOTHY SHELTON (LCSW)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:SHELTON
Last Name:BANDELL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 PATTON AVE UNIT 6052
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28816-4503
Mailing Address - Country:US
Mailing Address - Phone:443-629-5648
Mailing Address - Fax:
Practice Address - Street 1:390 MERRIMON AVE STE 4
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-1222
Practice Address - Country:US
Practice Address - Phone:828-581-9508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-05
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0101871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical