Individual
MR. RONALD LEE TIMMCKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A
Contact information
Practice address
4253 MONTGOMERY BLVD NE, SUITE 220, ALBUQUERQUE, NM 87109-1106
(505) 342-0400
(505) 342-0500
Mailing address
13204 SILVER PEAK PL NE, ALBUQUERQUE, NM 87111-8261
(505) 850-7301
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
3907
NM
101YM0800X
Mental Health Counselor
Primary
2741
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000189347
OPTUM HEALTH NEW MEXICO
NM
01
—
1054648
CIGNA BEHAVIORAL HEALTH INC.
NM
01
—
43728
PRESBYTERIAN
NM
05
—
Z4928
—
NM
Enumeration date
06/01/2010
Last updated
09/23/2013
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