Jaden Laeauna Cisco

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Williamson, WV

NPI 1467378398 · NPPES record last updated Jun 25, 2026

Key facts

NPI
1467378398
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
1609 W 3Rd Ave
Williamson, WV 25661-3006
Phone
(304) 443-4562
NPI assigned
Jun 25, 2026
Sex
Female
Sole proprietor
No

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
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes

Addresses

Primary practice location

1609 W 3Rd Ave
Williamson, WV 25661-3006

Mailing address

PO Box 613
Williamson, WV 25661-0613
Phone (304) 443-4562

Other providers in Williamson, WV

All providers in Williamson, WV · Addiction (Substance Use Disorder) Counselor in West Virginia

Sources for this page

Verify at the official NPI Registry.