Provider Demographics
NPI:1033910856
Name:MCLAUGHLIN, TIMOTHY W (MSW, DSP, MHSS)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:W
Last Name:MCLAUGHLIN
Suffix:
Gender:M
Credentials:MSW, DSP, MHSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 CUMBERLAND AVE APT 22
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-2818
Mailing Address - Country:US
Mailing Address - Phone:207-431-8152
Mailing Address - Fax:
Practice Address - Street 1:50 LYDIA LN
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-2156
Practice Address - Country:US
Practice Address - Phone:207-956-2559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC245001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical