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Individual

JACOB CLINEBELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.A.

Contact information

Practice address
1111 E END BLVD, WILKES BARRE, PA 18711-0030
(570) 824-3521
Mailing address
1111 E END BLVD, WILKES BARRE, PA 18711-0030
(570) 824-3520

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PC010455
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1326173360
PA
01
PC010455
PENNSYLVANIA STATE LICENSED PROFESSIONAL COUNSELOR LICENSE
PA
Enumeration date
05/29/2014
Last updated
05/29/2024
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