Provider Demographics
NPI:1487281085
Name:FLYNN, TIMOTHY ANDREW (LMHC)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:ANDREW
Last Name:FLYNN
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 PENNSYLVANIA AVE
Mailing Address - Street 2:SUITE #305
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50316
Mailing Address - Country:US
Mailing Address - Phone:515-263-4004
Mailing Address - Fax:515-263-4010
Practice Address - Street 1:1301 PENNSYLVANIA AVE
Practice Address - Street 2:SUITE #305
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50316
Practice Address - Country:US
Practice Address - Phone:515-263-4004
Practice Address - Fax:515-263-4010
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA075166101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor