Provider Demographics
NPI:1275929614
Name:CARMAN, TIM (LPCC)
Entity Type:Individual
Prefix:
First Name:TIM
Middle Name:
Last Name:CARMAN
Suffix:
Gender:M
Credentials:LPCC
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 188
Mailing Address - Street 2:
Mailing Address - City:WILLISBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40078-0188
Mailing Address - Country:US
Mailing Address - Phone:859-375-9200
Mailing Address - Fax:859-375-9202
Practice Address - Street 1:975 HUSTONVILLE RD STE 7
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-2165
Practice Address - Country:US
Practice Address - Phone:859-239-9598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-13
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY00218271101YM0800X
KY244480101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health