Provider Demographics
NPI:1932344819
Name:ADAMS, TIMOTHY YORK (LPC)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:YORK
Last Name:ADAMS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:MR
Other - First Name:T
Other - Middle Name:YORK
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:1100 WILLITS RD
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49058-9514
Mailing Address - Country:US
Mailing Address - Phone:616-889-7340
Mailing Address - Fax:
Practice Address - Street 1:1100 WILLITTS RD
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MI
Practice Address - Zip Code:49058
Practice Address - Country:US
Practice Address - Phone:616-889-7340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011106101YP1600X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral