Provider Demographics
NPI:1497403000
Name:STURRUP, TIMOTHY ALEXANDER (BA)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:ALEXANDER
Last Name:STURRUP
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 ARBOR RD
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-8980
Mailing Address - Country:US
Mailing Address - Phone:570-977-9300
Mailing Address - Fax:
Practice Address - Street 1:115 ARBOR RD
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-8980
Practice Address - Country:US
Practice Address - Phone:570-977-9300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-13
Last Update Date:2022-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral