Provider Demographics
NPI:1891686358
Name:TIMAN, STASIA
Entity type:Individual
Prefix:
First Name:STASIA
Middle Name:
Last Name:TIMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 MIDDLE RIVER RD
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-2736
Mailing Address - Country:US
Mailing Address - Phone:203-482-5898
Mailing Address - Fax:
Practice Address - Street 1:216 MIDDLE RIVER RD
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-2736
Practice Address - Country:US
Practice Address - Phone:203-482-5898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-14
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT008454101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional