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Individual

CHAD A JAKUBOWSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPCC/LICDC

Contact information

Practice address
40722 STATE ROUTE 154, LISBON, OH 44432-8500
(330) 424-9573
(330) 424-0877
Mailing address
PO BOX 429, LISBON, OH 44432-0429
(330) 424-9573
(330) 424-0877

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC.161054
OH
101YP2500X
Professional Counselor
C1300409
OH
101YP2500X
Professional Counselor
Primary
E.1600045
OH

Other

Enumeration date
01/31/2015
Last updated
02/17/2017
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