Provider Demographics
NPI:1215999651
Name:TIMIN, SHELDON M (LCSW-C)
Entity type:Individual
Prefix:
First Name:SHELDON
Middle Name:M
Last Name:TIMIN
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9105 FRANKLIN SQUARE DR
Mailing Address - Street 2:SUITES 104
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-3930
Mailing Address - Country:US
Mailing Address - Phone:443-777-7785
Mailing Address - Fax:
Practice Address - Street 1:9105 FRANKLIN SQUARE DR
Practice Address - Street 2:SUITES 102/103
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3930
Practice Address - Country:US
Practice Address - Phone:443-777-7878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR10121Medicare UPIN