Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MRS. BRENDA LAVONNE JACOB, MS, CCDC III, LAT
Active Sole ProprietorMRS. BRENDA LAVONNE JACOB, MS, CCDC III, LAT is a Addiction (Substance Use Disorder) Counselor healthcare provider located in GILLETTE, Wyoming. NPI 1780812214 is currently active in the NPPES registry. Verify at CMS.
Addiction (Substance Use Disorder) Counselor · GILLETTE, WY
Registration Details
- NPI Number
- 1780812214
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 23, 2009 (17.186947210278 yrs)
- Last Updated
- Jun 23, 2009
- Licenses
-
LAT-270 (WY)99111065 (SD)
- Sole Proprietor
- Yes
Practice Information
- Address
-
113 S GILLETTE AVEGILLETTE, WY, 827163740Browse WY providers · Browse ZIP 82716
- Phone
- 3076856982
- Fax
- 3076858054
- Primary Specialty
-
Addiction (Substance Use Disorder) Counselor
101YA0400X
- Additional Specialty
- Addiction (Substance Use Disorder) Counselor
Other Addiction (Substance Use Disorder) Counselor Providers in GILLETTE, WY
| Name | Credential | NPI |
|---|---|---|
| MR. MARTY RAY HUCKINS | CAP, CCDC III, ICADC | 1356624019 |
| WHITNEY NICHOLE HELLER | — | 1124766639 |
| STEPHEN HARBOUR | — | 1093424426 |
| RENEE HARNISH | MS, PAT | 1821856873 |
| STEFANIE KAE KAPINUS | PAT | 1992538425 |
| PENNY SUE HANSEN | — | 1699640946 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.