Individual
MR. JACOB RENICK LAUVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, MBA, CADC, LCDC
Contact information
Practice address
1450 MADISON AVE, COVINGTON, KY 41011-3369
(859) 444-4499
Mailing address
1450 MADISON AVE, COVINGTON, KY 41011-3369
(859) 444-4499
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
247532
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04032015
—
KY
Enumeration date
04/08/2019
Last updated
04/08/2019
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