Provider Demographics
NPI:1689730509
Name:HANDORF, TIMOTHY PATRICK (LICSW)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:PATRICK
Last Name:HANDORF
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 LINCOLN ST
Mailing Address - Street 2:#210
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-1760
Mailing Address - Country:US
Mailing Address - Phone:781-749-2089
Mailing Address - Fax:781-749-0628
Practice Address - Street 1:185 LINCOLN ST
Practice Address - Street 2:#210
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-1760
Practice Address - Country:US
Practice Address - Phone:781-749-2089
Practice Address - Fax:781-749-0628
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1048531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical