Provider Demographics
NPI:1982438776
Name:COUTO, TIMOTHY (MA, LMHC)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:COUTO
Suffix:
Gender:M
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-2269
Mailing Address - Country:US
Mailing Address - Phone:508-655-9200
Mailing Address - Fax:
Practice Address - Street 1:31 UNION AVE
Practice Address - Street 2:
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776-2269
Practice Address - Country:US
Practice Address - Phone:508-655-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALMHC10001718101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health