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Individual
MR. TIMMY J.K. SO
Active
Individual
MR. TIMMY J.K. SO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW-R
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
083303
NY
103TC1900X
Counseling Psychologist
083303
NY
104100000X
Social Worker
Primary
083303
NY
1041C0700X
Clinical Social Worker
086100
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00932467
—
NY
Enumeration date
09/23/2011
Last updated
07/08/2021
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