Provider Demographics
NPI:1881068609
Name:TIMMONS, CODY SCOTT (LMHC)
Entity type:Individual
Prefix:MR
First Name:CODY
Middle Name:SCOTT
Last Name:TIMMONS
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 RANDOLPH AVE
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-4009
Mailing Address - Country:US
Mailing Address - Phone:903-520-6901
Mailing Address - Fax:
Practice Address - Street 1:325 RANDOLPH AVE
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186-4009
Practice Address - Country:US
Practice Address - Phone:978-595-2019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-17
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68525101YM0800X
MA10638101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health