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NPI Code Detail

MEDICARE: MR. KENNETH LLOYD JR. LICDC, LSW

MEDICARE: MR. KENNETH LLOYD JR. LICDC, LSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor841092OH
2104100000XSocial WorkerS,0016334OH

General Provider Information

NPI Number : 1003038258
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KENNETH LLOYD JR. LICDC, LSW
Provider Business Mailing Address
First Line : 320 HIGH ST NE
Second Line :
City : WARREN
State : OH
Zip : 44481-1222
Country : US
Telephone Number : 330-394-9090
Fax Number : 330-394-8163
Provider Business Practice Location Address
First Line : 320 HIGH ST NE
Second Line :
City : WARREN
State : OH
Zip : 44481-1222
Country : US
Telephone Number : 330-394-9090
Fax Number : 330-394-8163
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2007
Last Update Date : 09/11/2025

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