Provider Demographics
NPI:1487179909
Name:GIVAN, TIMOTHY (CNTP)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:
Last Name:GIVAN
Suffix:
Gender:M
Credentials:CNTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 BARASINGHA ST
Mailing Address - Street 2:
Mailing Address - City:SEVERANCE
Mailing Address - State:CO
Mailing Address - Zip Code:80550-3813
Mailing Address - Country:US
Mailing Address - Phone:303-725-2553
Mailing Address - Fax:
Practice Address - Street 1:914 BARASINGHA ST
Practice Address - Street 2:
Practice Address - City:SEVERANCE
Practice Address - State:CO
Practice Address - Zip Code:80550-3813
Practice Address - Country:US
Practice Address - Phone:303-725-2553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-04
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO133N00000X, 133NN1002X, 1744G0900X
174400000X, 225800000X, 171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No174400000XOther Service ProvidersSpecialist
No1744G0900XOther Service ProvidersSpecialistGraphics Designer
No225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist