Basic Information
| Provider Information | |||||||||
| NPI: | 1649788852 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BEGIN | ||||||||
| FirstName: | TIMOTHY | ||||||||
| MiddleName: | PATRICK | ||||||||
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| Mailing Information | |||||||||
| Address1: | 283 STILL HILL RD | ||||||||
| Address2: | |||||||||
| City: | HAMDEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065181830 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2036406777 | ||||||||
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| Practice Location | |||||||||
| Address1: | 351 SILVER ST | ||||||||
| Address2: | |||||||||
| City: | MIDDLETOWN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064573919 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8602625200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2018 | ||||||||
| LastUpdateDate: | 01/22/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 010009 | CT | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.