Provider Demographics
NPI:1437942471
Name:HUMPHREYS, TIMOTHY OWEIN
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:OWEIN
Last Name:HUMPHREYS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3930 PENDER DR STE 350
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-0989
Mailing Address - Country:US
Mailing Address - Phone:703-865-8686
Mailing Address - Fax:703-865-6506
Practice Address - Street 1:3930 PENDER DR STE 350
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-0989
Practice Address - Country:US
Practice Address - Phone:703-865-6565
Practice Address - Fax:703-865-6506
Is Sole Proprietor?:No
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor