Provider Demographics
NPI:1487341822
Name:SOBIECH, TIMOTHY PAUL (CADC-I, NCCPSS)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:PAUL
Last Name:SOBIECH
Suffix:
Gender:M
Credentials:CADC-I, NCCPSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3138 PROVIDENCE MILL RD
Mailing Address - Street 2:
Mailing Address - City:MAIDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28650-8544
Mailing Address - Country:US
Mailing Address - Phone:704-775-0016
Mailing Address - Fax:
Practice Address - Street 1:2415 MORGANTON BLVD SW
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-9691
Practice Address - Country:US
Practice Address - Phone:828-394-5563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2023-6377-01175T00000X
NCCADC-26357101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No175T00000XOther Service ProvidersPeer Specialist