Healthcare Provider Details

I. General information

NPI: 1063773737
Provider Name (Legal Business Name): IRONTON & LAWRENCE COUNTY AREA COMMUNITY ACTION ORGANIZATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2012
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 N 3RD ST
IRONTON OH
45638-1574
US

IV. Provider business mailing address

305 N 5TH ST
IRONTON OH
45638-1578
US

V. Phone/Fax

Practice location:
  • Phone: 740-532-7855
  • Fax: 740-532-0557
Mailing address:
  • Phone: 740-532-3534
  • Fax: 740-532-4859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KELLY ADKINS
Title or Position: CFO
Credential:
Phone: 740-532-3534