Provider Demographics
NPI:1538871025
Name:ALLEN, TIMOTHY EUGENE (LPC)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:EUGENE
Last Name:ALLEN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 PARK TEN BLVD STE 200S
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-4293
Mailing Address - Country:US
Mailing Address - Phone:210-261-1060
Mailing Address - Fax:210-261-1821
Practice Address - Street 1:601 N FRIO ST BLDG 1
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-3011
Practice Address - Country:US
Practice Address - Phone:210-246-1300
Practice Address - Fax:210-227-5476
Is Sole Proprietor?:No
Enumeration Date:2022-12-16
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX84833101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX20107915OtherDL