Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. KENNETH VINCENT BASCOM JR., MA
Active Sole ProprietorMR. KENNETH VINCENT BASCOM JR., MA is a Addiction (Substance Use Disorder) Counselor healthcare provider located in HONESDALE, Pennsylvania. NPI 1861048159 is currently active in the NPPES registry. Verify at CMS.
Addiction (Substance Use Disorder) Counselor · HONESDALE, PA
Registration Details
- NPI Number
- 1861048159
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 13, 2019 (6.9805954996163 yrs)
- Last Updated
- Aug 13, 2019
- License
-
647010 (PA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1855 FAIR AVEHONESDALE, PA, 184312121Browse PA providers · Browse ZIP 18431
- Phone
- 5702533980
- Fax
- 5702533982
- Primary Specialty
-
Addiction (Substance Use Disorder) Counselor
101YA0400X
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.