Provider Demographics
NPI:1902183577
Name:THE TIMOTHY CENTER, INC.
Entity Type:Organization
Organization Name:THE TIMOTHY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:KYLE
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC-S
Authorized Official - Phone:512-331-2700
Mailing Address - Street 1:11754 JOLLYVILLE RD STE 110
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-3948
Mailing Address - Country:US
Mailing Address - Phone:512-331-2700
Mailing Address - Fax:512-219-5097
Practice Address - Street 1:11754 JOLLYVILLE RD STE 110
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-3948
Practice Address - Country:US
Practice Address - Phone:512-331-2700
Practice Address - Fax:512-219-5097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-10
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63765101YP2500X
261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty