Provider Demographics
NPI:1366291460
Name:HYER-DEVINE, TIMOTHY A (LPC)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:A
Last Name:HYER-DEVINE
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:N92W17455 APPLETON AVE LOT 40
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-1301
Mailing Address - Country:US
Mailing Address - Phone:920-918-1576
Mailing Address - Fax:
Practice Address - Street 1:1035 W GLEN OAKS LN STE 110
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-3394
Practice Address - Country:US
Practice Address - Phone:920-918-1576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-13
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11032-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional