Timothy Jay Donahue, BGS BSRCE CADC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Burlington, KS

NPI 1740447168 · NPPES record last updated May 22, 2008

Key facts

NPI
1740447168
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
420 Kennedy St
Burlington, KS 66839-1120
Phone
(620) 364-2606
Fax
(620) 364-2551
NPI assigned
May 22, 2008
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

420 Kennedy St
Burlington, KS 66839-1120

Mailing address

420 Kennedy St
Burlington, KS 66839-1120
Phone (620) 364-2606

Other identifiers

IdentifierTypeStateIssuer
AAPSOtherKSAAPS
BSRCEOtherKSBSRCE

Other providers in Burlington, KS

All providers in Burlington, KS · Addiction (Substance Use Disorder) Counselor in Kansas

Sources for this page

Verify at the official NPI Registry.