Healthcare Provider Details

I. General information

NPI: 1164043071
Provider Name (Legal Business Name): JENNIFER SOBOL LMHC, LPC, LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2020
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9780 WOODRIFF CIR
LELAND NC
28451-4402
US

IV. Provider business mailing address

9780 WOODRIFF CIR
LELAND NC
28451-4402
US

V. Phone/Fax

Practice location:
  • Phone: 910-800-0627
  • Fax:
Mailing address:
  • Phone: 910-800-0627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC8723
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number010051
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00938700
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number20840
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: