Individual
MR. JAY OWEN WAINSCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCC, LICDC-CS
Contact information
Practice address
6239 WILMINGTON PIKE, CENTERVILLE, OH 45459-7108
(937) 319-4448
(937) 630-4391
Mailing address
6020 COBBLESKILL CT, CENTERVILLE, OH 45459-2136
(937) 689-6528
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC.111040
OH
101YM0800X
Mental Health Counselor
Primary
E.1700023-SUPV
OH
Other
Enumeration date
06/18/2018
Last updated
06/18/2018
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