Individual
IAN JENNINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDCA.193079
Contact information
Practice address
323 MARION PIKE STE 1, COAL GROVE, OH 45638-2958
(740) 237-4981
(877) 325-2816
Mailing address
323 MARION PIKE STE 1, COAL GROVE, OH 45638-2958
(740) 237-4981
(877) 325-2816
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.193079
OH
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0071394
—
OH
Enumeration date
10/07/2024
Last updated
02/25/2026
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