Provider Demographics
NPI:1851471718
Name:HALLINAN, TIMOTHY W (MSW, PHD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:W
Last Name:HALLINAN
Suffix:
Gender:M
Credentials:MSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2477 STICKNEY POINT RD
Mailing Address - Street 2:SUITE 319-B
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-4076
Mailing Address - Country:US
Mailing Address - Phone:941-921-2423
Mailing Address - Fax:941-925-1746
Practice Address - Street 1:2477 STICKNEY POINT RD
Practice Address - Street 2:SUITE 319-B
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-4076
Practice Address - Country:US
Practice Address - Phone:941-921-2423
Practice Address - Fax:941-925-1746
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW00014691041C0700X
FLMT0001122106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ1112Medicare UPIN