Provider Demographics
NPI:1649324179
Name:TIMIN, PAUL L (LCSW C MSW)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:L
Last Name:TIMIN
Suffix:
Gender:M
Credentials:LCSW C MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 YORK RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093
Mailing Address - Country:US
Mailing Address - Phone:410-321-9338
Mailing Address - Fax:410-823-6204
Practice Address - Street 1:1402 YORK RD
Practice Address - Street 2:SUITE 207
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093
Practice Address - Country:US
Practice Address - Phone:410-321-9338
Practice Address - Fax:410-823-6204
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD007991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDB003OtherLEGACY NUMBER
R09848Medicare UPIN