Provider Demographics
NPI:1871671982
Name:HYNICK, TIMOTHY (PSYD)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:
Last Name:HYNICK
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 MILL ST
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-4153
Mailing Address - Country:US
Mailing Address - Phone:978-372-5445
Mailing Address - Fax:
Practice Address - Street 1:324 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH READING
Practice Address - State:MA
Practice Address - Zip Code:01864-1329
Practice Address - Country:US
Practice Address - Phone:978-664-2566
Practice Address - Fax:978-664-8023
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7397103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA043114833-11OtherPACIFICARE BEHAVIORAL HEA
MA467317OtherTUFTS HEALTH PLAN
MA467317OtherTUFTS BENEFIT ADMINISTR
MA467317OtherTUFTS LIBERTY
MAW06245OtherBCBS OF MA