Provider Demographics
NPI:1922364470
Name:ROLFE, TIMOTHY JAY (LCSW, PIP)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:JAY
Last Name:ROLFE
Suffix:
Gender:M
Credentials:LCSW, PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 FRANKFORD AVE (BLDG 221)
Mailing Address - Street 2:ANNISTON ARMY DEPOT
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36201
Mailing Address - Country:US
Mailing Address - Phone:256-453-4745
Mailing Address - Fax:
Practice Address - Street 1:7 FRANKFORD AVE (BLDG 221)
Practice Address - Street 2:ANNISTON ARMY DEPOT
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36201
Practice Address - Country:US
Practice Address - Phone:256-453-4745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-10
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical