Healthcare Provider Details

I. General information

NPI: 1669243002
Provider Name (Legal Business Name): ALICE BRINKLEY HOBIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2024
Last Update Date: 01/15/2024
Certification Date: 01/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14057 US HIGHWAY 17 STE 200
HAMPSTEAD NC
28443-3793
US

IV. Provider business mailing address

306 ROYAL PALM AVE
SURF CITY NC
28445-6941
US

V. Phone/Fax

Practice location:
  • Phone: 910-821-1418
  • Fax: 866-860-0997
Mailing address:
  • Phone: 919-522-6656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA19571
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: