Sober Ict, Inc

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

SOBER ICT, INC

Practice address

200 W Douglas Ave Ste 360
Wichita, KS 67202-3019

Phone

(316) 833-2739

NPI assigned

Nov 4, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Gerald L Vaillancourt Jr., MA, LACNPI 1982562831

Title

Director

Phone

(316) 833-2739

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gerald L Vaillancourt Jr., LAC1596

  • Addiction (Substance Use Disorder) Counselor
  • Wichita, KS
  • NPI 1982562831
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1730678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730678400000",
    "number": "1932922473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W DOUGLAS AVE STE 360",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672023019",
            "telephone_number": "316-833-2739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W DOUGLAS AVE STE 360",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672023019",
            "telephone_number": "316-833-2739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOBER ICT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-04",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A",
        "authorized_official_last_name": "VAILLANCOURT",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "316-833-2739",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MA, LAC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Lynn Sobba-Worrell, DDS
• Angela Kay Sobba, APRN
• Steven Sobba, CRNA
• Jackson Sobbing, DO
• Sober City LLC
• Krista Lynn Sobrino, PMHNP
• Hassan Sohail
• Olga Gennadyevna Sokolova, MD
• Sol Systems Inc
• Mariah Solcher

• Substance Abuse Rehabilitation Facility in Wichita, KS
• Providers in Wichita, KS by specialty
• Substance Abuse Rehabilitation Facility in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.