Provider Demographics
NPI:1003529306
Name:PLUCINSKY, TIMOTHY (MA, LPCC)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:PLUCINSKY
Suffix:
Gender:M
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8244 W ILIFF LN
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-3060
Mailing Address - Country:US
Mailing Address - Phone:720-284-9625
Mailing Address - Fax:
Practice Address - Street 1:8244 W ILIFF LN
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-3060
Practice Address - Country:US
Practice Address - Phone:720-284-9625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-02
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0020312101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor