Provider Demographics
NPI:1225460850
Name:PRIMEAUX, TIMOTHY (LMHC, SUDP)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:PRIMEAUX
Suffix:
Gender:M
Credentials:LMHC, SUDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3805 108TH AVE NE STE 204
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-7613
Mailing Address - Country:US
Mailing Address - Phone:425-242-1713
Mailing Address - Fax:
Practice Address - Street 1:3805 108TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-7613
Practice Address - Country:US
Practice Address - Phone:425-624-1756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP60298435101YA0400X
WALH60324713101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor