Timmy Ryan Thayne, MFT
Individual provider Active NPI Marriage & Family Therapist · Alpine, UT
NPI 1124335641 · NPPES record last updated Sep 3, 2010
Key facts
- NPI
- 1124335641
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 368382-3902 (UT)
- Practice address
- 256 N Main St
Alpine, UT 84004-1476 - Phone
- (801) 768-1441
- Fax
- (801) 705-0333
- NPI assigned
- Sep 3, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 368382-3902 | UT | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Homeward Bound | Marriage & Family Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 368382-3902 | UT | Yes |
Addresses
Primary practice location
256 N Main St
Alpine, UT 84004-1476
Mailing address
770 E Main St # 215
Lehi, UT 84043-2293
Phone (801) 768-1441
Other providers in Alpine, UT
- Jay Lynn Steineckert
- Alayna Stinson
- Grant Turner Stucki
- Randall McKay Stucki
- Rebekah S Tayebi
- Therapycorp LLC
- Madison Townsend
- Traverse Family Therapy LLC
- Triple Ccca
- Vernon C. Utley
All providers in Alpine, UT · Marriage & Family Therapist in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.