Provider Demographics
NPI:1336946334
Name:EDWARDS, TIMOTHY (MS LPC)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 N SPRING ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79107-7330
Mailing Address - Country:US
Mailing Address - Phone:806-206-4585
Mailing Address - Fax:
Practice Address - Street 1:2401 N SPRING ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79107-7330
Practice Address - Country:US
Practice Address - Phone:806-206-4585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15702101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health