Provider Demographics
NPI:1659345296
Name:MAVERGEORGE, TIMOTHY MARK (MA, LPC, LMFT, LCDC)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:MARK
Last Name:MAVERGEORGE
Suffix:
Gender:M
Credentials:MA, LPC, LMFT, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13333 SOUTHWEST FWY
Mailing Address - Street 2:#230
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3581
Mailing Address - Country:US
Mailing Address - Phone:281-277-8811
Mailing Address - Fax:281-277-8827
Practice Address - Street 1:13333 SOUTHWEST FWY
Practice Address - Street 2:#230
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3581
Practice Address - Country:US
Practice Address - Phone:281-277-8811
Practice Address - Fax:281-277-8827
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX10070101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional