MEDICARE: MR. TIMOTHY C TRUEMPER M.S., LPA, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	4251	NC
2	103T00000X	Psychologist	1251	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1251	OTHER	NC	PSYCHOLOGY LICENSE NUMBER
2	4251	OTHER	NC	LPC NUMBER

General Provider Information

NPI Number	:	1720156979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TIMOTHY C TRUEMPER M.S., LPA, LPC

Provider Business Mailing Address
First Line	:	126 MITCHELL AVE
Second Line	:
City	:	SALISBURY
State	:	NC
Zip	:	28144-6239
Country	:	US
Telephone Number	:	704-637-2493
Fax Number	:

Provider Business Practice Location Address
First Line	:	1065 VINEHAVEN DR
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28025-2439
Country	:	US
Telephone Number	:	704-786-9181
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	08/21/2007

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Directions to “ MR. TIMOTHY C TRUEMPER M.S., LPA, LPC” Practice Location

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