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Individual
MR. TODD B. JETER
Active
Individual
MR. TODD B. JETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, CADC III
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16-11-18
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
19-01-20
OR
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
L10427
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500725923
—
OR
05
—
500731705
—
OR
Enumeration date
12/20/2016
Last updated
06/03/2026
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