Healthcare Provider Details

I. General information

NPI: 1922518430
Provider Name (Legal Business Name): JAMES HOBSON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2017
Last Update Date: 10/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1043 COBBLESTONE BLVD
SUMMERVILLE SC
29486-2083
US

IV. Provider business mailing address

1317M N MAIN ST STE 318
SUMMERVILLE SC
29483-7307
US

V. Phone/Fax

Practice location:
  • Phone: 559-790-5659
  • Fax: 843-371-7717
Mailing address:
  • Phone: 843-620-1570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: