Jeffery Thomas Ackerly, ADDICTIONS COUNSELOR

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Eureka, CA

NPI 1497263321 · NPPES record last updated Mar 17, 2018

Key facts

NPI: 1497263321
Entity type: Individual (NPI type 1)
Primary specialty: Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address: 1303 11TH St
Eureka, CA 95501-2028
Phone: (707) 443-4237
Fax: (707) 460-3380
NPI assigned: Jan 12, 2018
Sex: Male
Sole proprietor: Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Humboldt Recovery Center Inc., Substance Abuse Rehabilitation Facility · Eureka, CA · NPI 1073023107

NPD (past)

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): No

Practice roles

Organization	Specialty	Status	New patients
Humboldt Recovery Center Inc.,		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Addiction (Substance Use Disorder) Counselor	101YA0400X			Yes

Addresses

Primary practice location

1303 11TH St
Eureka, CA 95501-2028

Mailing address

PO Box 6310
Eureka, CA 95502-6310
Phone (707) 444-6262

Other practice location 1

1116 9th St
Eureka, CA 95501-1936
Phone (707) 444-6262

Other practice location 2

1219 10th St
Eureka, CA 95501-2024
Phone (707) 444-6262

Other practice location 3

905N L St
Eureka, CA 95501-1943

Other practice location 4

944 N St
Eureka, CA 95501-2045
Phone (707) 444-6262

Other practice location 5

1024 N St
Eureka, CA 95501-2047
Phone (707) 444-6262

Other practice location 6

1120 9th St
Eureka, CA 95501-1936
Phone (707) 444-6262

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Thad L Ackerman Sr.
Active Care Chiropractic, Fogg Professional Corporation
Rachael Adair, CNM, PMHNP
Clare Walance Adams
Kimberlee Adams, NP

All providers in Eureka, CA · Addiction (Substance Use Disorder) Counselor in California

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2018. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.