TIMOTHY JERREAL WOOTEN LCMHC-A LCAS-A NCC NPI 1679195960

NPI Information

  • NPI: 1679195960
  • Provider Name: TIMOTHY JERREAL WOOTEN, LCMHC-A, LCAS-A, NCC
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • Address: 3708 LYCKAN PKWY STE 205
    DURHAM, NC
    ZIP 27707
  • Phone: (919) 809-9846

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NPI Details

Timothy Jerreal Wooten, LCMHC-A, LCAS-A, NCC is a mental health counselor in Durham, NC. Timothy Jerreal Wooten, LCMHC-A, LCAS-A, NCC NPI is 1679195960. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3708 LYCKAN PKWY STE 205
DURHAM, NC
ZIP 27707-586
Phone: (919) 809-9846
Fax: (919) 516-0057

The enumeration date for this NPI number is 5/11/2020 and was last updated on 5/11/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)25834NORTH CAROLINANo
2101YM0800XCounselorMental HealthA15640NORTH CAROLINAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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