Provider Demographics
NPI:1720156979
Name:TRUEMPER, TIMOTHY C (MS, LPA, LPC)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:C
Last Name:TRUEMPER
Suffix:
Gender:M
Credentials:MS, LPA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 MITCHELL AVE
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-6239
Mailing Address - Country:US
Mailing Address - Phone:704-637-2493
Mailing Address - Fax:
Practice Address - Street 1:1065 VINEHAVEN DR
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2439
Practice Address - Country:US
Practice Address - Phone:704-786-9181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4251101YM0800X
NC1251103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1251OtherPSYCHOLOGY LICENSE NUMBER
NC4251OtherLPC NUMBER