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General NPI Number Information
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NPI Number | 1487341822
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Entity Type | Individual
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Provider Name | TIMOTHY PAUL SOBIECH CADC-I, NCCPSS
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Gender | Male
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Dates
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Enumeration Date | 04/18/2023
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Last Update Date | 04/18/2023
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Provider Practice Location Address
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Address Line | 2415 MORGANTON BLVD SW
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City | LENOIR
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State | NC
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Zip | 28645-9691
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Country | US
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Telephone | 828-394-5563
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Fax |
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Provider Business Mailing Address
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Address Line | 3138 PROVIDENCE MILL RD
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City | MAIDEN
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State | NC
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Zip | 28650-8544
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Country | US
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Telephone | 704-775-0016
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | 2023-6377-01
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CADC-26357
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License Number State | NC
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