Healthcare Provider Details

I. General information

NPI: 1932670981
Provider Name (Legal Business Name): JACOB PRESTON HUCK M.ED, LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2018
Last Update Date: 01/31/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 WOLF LEDGES PKWY
AKRON OH
44311-1028
US

IV. Provider business mailing address

411 WOLF LEDGES PKWY
AKRON OH
44311-1028
US

V. Phone/Fax

Practice location:
  • Phone: 330-379-0667
  • Fax: 234-571-0107
Mailing address:
  • Phone: 330-379-0667
  • Fax: 234-571-0107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.2303642
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: