Healthcare Provider Details

I. General information

NPI: 1114556180
Provider Name (Legal Business Name): RONALD JOSEPH HOBBS JR. LCADC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2020
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 DIECKS DR
ELIZABETHTOWN KY
42701-2443
US

IV. Provider business mailing address

200 CLAYSVILLE LNDG APT 1H
ELIZABETHTOWN KY
42701-3241
US

V. Phone/Fax

Practice location:
  • Phone: 270-392-5267
  • Fax:
Mailing address:
  • Phone: 270-392-5267
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number284917
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number165001
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: