Provider Demographics
NPI:1558984807
Name:CRANFILL, TIMOTHY D (DMIN, DCOUN, LPC, BC)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:D
Last Name:CRANFILL
Suffix:
Gender:M
Credentials:DMIN, DCOUN, LPC, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 DANDELION BND
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78245-3358
Mailing Address - Country:US
Mailing Address - Phone:210-289-3224
Mailing Address - Fax:
Practice Address - Street 1:407 DANDELION BND
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245-3358
Practice Address - Country:US
Practice Address - Phone:210-289-3224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-21
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81271101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional