Individual
JACOB KERRY MCBRIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ACMHC
Contact information
Practice address
344 E 100 S, SALT LAKE CITY, UT 84111-1700
(801) 428-3443
Mailing address
344 E 100 S, SALT LAKE CITY, UT 84111-1700
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
10844181-6004
UT
101YM0800X
Mental Health Counselor
10844181-6009
UT
253J00000X
Foster Care Agency
—
—
Other
Enumeration date
07/25/2013
Last updated
10/04/2023
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