Provider Demographics
NPI:1114377470
Name:HORVATH, TIMOTHY (LMFT - A)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:HORVATH
Suffix:
Gender:M
Credentials:LMFT - A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 FIVE OAKS DR
Mailing Address - Street 2:#26
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-5286
Mailing Address - Country:US
Mailing Address - Phone:919-766-2846
Mailing Address - Fax:
Practice Address - Street 1:4100 FIVE OAKS DR
Practice Address - Street 2:#26
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-5286
Practice Address - Country:US
Practice Address - Phone:919-766-2846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-17
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11030A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist