Individual
JACQUELYN LAVENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC III
Contact information
Practice address
1455 S 4TH ST, COLUMBUS, OH 43207-1011
(614) 444-0800
(614) 444-1036
Mailing address
1455 S 4TH ST, COLUMBUS, OH 43207-1011
(614) 444-0800
(614) 444-1036
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDCIII.162533
OH
Other
Enumeration date
10/14/2016
Last updated
07/09/2024
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