Provider Demographics
NPI:1134346463
Name:TIMMERMAN, BARRY SCOTT (MA, LCMHC,MLADC)
Entity type:Individual
Prefix:MR
First Name:BARRY
Middle Name:SCOTT
Last Name:TIMMERMAN
Suffix:
Gender:M
Credentials:MA, LCMHC,MLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:867 LAFAYETTE RD
Mailing Address - Street 2:
Mailing Address - City:SEABROOK
Mailing Address - State:NH
Mailing Address - Zip Code:03874-4217
Mailing Address - Country:US
Mailing Address - Phone:603-474-3332
Mailing Address - Fax:603-372-0822
Practice Address - Street 1:867 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:SEABROOK
Practice Address - State:NH
Practice Address - Zip Code:03874-4217
Practice Address - Country:US
Practice Address - Phone:603-474-3332
Practice Address - Fax:603-372-0822
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0282101YA0400X
NH311101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)