Provider Demographics
NPI:1437242310
Name:WELCH, TIMOTHY J (LPCC, MAC, BC-TMH)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:J
Last Name:WELCH
Suffix:
Gender:M
Credentials:LPCC, MAC, BC-TMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1474 E QUAIL RUN DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-9271
Mailing Address - Country:US
Mailing Address - Phone:740-364-8846
Mailing Address - Fax:740-756-6207
Practice Address - Street 1:1474 E QUAIL RUN DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-9271
Practice Address - Country:US
Practice Address - Phone:740-200-0799
Practice Address - Fax:740-756-6207
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0004200-SUPV101YP2500X
OHE-0004200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional