Jakob Buchanan

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Bryan, OH

NPI 1124708243 · NPPES record last updated Jul 24, 2023

Key facts

NPI
1124708243
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
1254 S Main St
Bryan, OH 43506-2441
Phone
(440) 260-6835
NPI assigned
Jul 24, 2023
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes

Addresses

Primary practice location

1254 S Main St
Bryan, OH 43506-2441

Mailing address

434 Eastland Rd
Berea, OH 44017-1217
Phone (440) 234-2006

Other providers in Bryan, OH

All providers in Bryan, OH · Addiction (Substance Use Disorder) Counselor in Ohio

Sources for this page

Verify at the official NPI Registry.