Individual
LIVINUS C UBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ICADC, LCDCIII, CADC
Contact information
Practice address
3655 WINCHESTER AVE, ASHLAND, KY 41101-2065
(606) 393-4632
(888) 411-4131
Mailing address
3655 WINCHESTER AVE, ASHLAND, KY 41101-2065
(606) 393-4632
(888) 411-4131
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
121019
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
128644
ZZ
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
166426
KY
101YA0400X
Addiction (Substance Use Disorder) Counselor
710053
ZZ
Other
Enumeration date
08/07/2012
Last updated
03/22/2024
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