Timothy Anderson, PH.D.
Individual provider Active NPI Clinical Psychologist · Athens, OH
NPI 1649700550 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1649700550
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 5117 (OH)
- Practice address
- 1 Ohio University Psychology and Social Work Clinic
Room 002 Athens, Oh 45701-2942 United States
Athens, OH 45701-2942 - Phone
- (740) 593-0902
- Fax
- (740) 593-4790
- NPI assigned
- Jun 13, 2017
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5117 | OH | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 5117 | OH | Yes |
Addresses
Primary practice location
1 Ohio University Psychology and Social Work Clinic
Room 002 Athens, Oh 45701-2942 United States
Athens, OH 45701-2942
Mailing address
1 Ohio University Psychology and Social Work Clinic
Room 002 Athens, Oh 45701-2942 United States
Athens, OH 45701-2942
Phone (740) 593-0902
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103TC0700X | Other | OH | CLINICAL PSYCHOLOGIST |
Other providers in Athens, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. 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.