Provider Demographics
NPI:1528410974
Name:SERRANO, TIMOTHY
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:SERRANO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:TIMOTHY
Other - Middle Name:
Other - Last Name:SERRANO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:1402 VILLAGE DR STE A
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-4157
Mailing Address - Country:US
Mailing Address - Phone:361-570-1444
Mailing Address - Fax:361-570-1446
Practice Address - Street 1:1402 VILLAGE DR STE A
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-4157
Practice Address - Country:US
Practice Address - Phone:361-570-1444
Practice Address - Fax:361-570-1444
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-11
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX93171101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health