Provider Demographics
NPI:1811919798
Name:ALFREY, TIM J (MA, LPC)
Entity type:Individual
Prefix:MR
First Name:TIM
Middle Name:J
Last Name:ALFREY
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:MR
Other - First Name:TIM
Other - Middle Name:J
Other - Last Name:ALFREY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LPC
Mailing Address - Street 1:6525 LANCASTER CIR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-7336
Mailing Address - Country:US
Mailing Address - Phone:678-455-5221
Mailing Address - Fax:678-455-5221
Practice Address - Street 1:6525 LANCASTER CIR
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-7336
Practice Address - Country:US
Practice Address - Phone:678-455-5221
Practice Address - Fax:678-455-5221
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0001569101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional