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NPI Code Detail

MEDICARE: MR. JACOB L WRIGHT

MEDICARE: MR. JACOB L WRIGHT
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
1101YP2500XProfessional Counselor175202KY

General Provider Information

NPI Number : 1952760126
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JACOB L WRIGHT
Provider Business Mailing Address
First Line : 615 ELSINORE PL STE 200
Second Line :
City : CINCINNATI
State : OH
Zip : 45202-1457
Country : US
Telephone Number : 833-510-4357
Fax Number : 866-460-2997
Provider Business Practice Location Address
First Line : 500 N GREEN ST
Second Line :
City : HENDERSON
State : KY
Zip : 42420-2948
Country : US
Telephone Number : 833-510-4357
Fax Number : 866-460-2997
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2016
Last Update Date : 03/07/2022

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