Provider Demographics
NPI:1265445811
Name:HOWELL, TIMOTHY ROGER (MA LPC)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:ROGER
Last Name:HOWELL
Suffix:
Gender:M
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1589
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-1589
Mailing Address - Country:US
Mailing Address - Phone:503-636-4176
Mailing Address - Fax:
Practice Address - Street 1:13347 SW ALLEN BLVD
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-4590
Practice Address - Country:US
Practice Address - Phone:503-636-4176
Practice Address - Fax:503-625-2863
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1194101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional