Individual
MR. TIMOTHY ROBERT MCKAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
152 DEMING ST, SOUTH WINDSOR, CT 06074-3740
(860) 713-1184
(860) 200-2863
Mailing address
152 DEMING ST, SOUTH WINDSOR, CT 06074-3740
(860) 713-1184
(860) 200-2863
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2392
CT
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1324623
BUSINESS ID
CT
01
—
14611280
CAQH
—
01
—
84-3402714
IRS
—
Enumeration date
08/22/2019
Last updated
11/11/2024
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