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Individual

TIMOTHY J. FLYNN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.S.

Contact information

Practice address
1415 EAST GREEN BAY ST.,, STE 191 SYNERGY COUNSELING SERVICES, SC, SHAWANO, WI 54166-3881
(715) 526-5466
(715) 526-5545
Mailing address
1415 EAST GREEN BAY ST.,, STE. 191 SYNERGY COUNSELING SERVICES, SC, SHAWANO, WI 54166-3881
(715) 526-5466
(715) 526-5545

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
10996
WI
101Y00000X
Counselor
653125
WI
104100000X
Social Worker
10996-131
WI
104100000X
Social Worker
Primary
653-125
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11678256
CAQH
05
39254500
WI
Enumeration date
10/02/2006
Last updated
08/31/2009
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