Goodrum, Kevon Jabarr

Goodrum, Kevon Jabarr is an individual health care provider with primary practice located at 46 Ridge Rd , Hamden CT 06517-3506. He recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as his primary health care specialty. Goodrum, Kevon Jabarr can be contacted via phone (203) 752-8827.

Contact Information

Primary practice address
46 Ridge Rd Hamden CT 06517-3506
Phone: (203) 752-8827
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X MFT001607 Georgia

Profile Details

NPI number 1831327006
LBN Legal business name Goodrum, Kevon Jabarr
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2009
Last updated Apr 27th, 2024 - about 7 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831327006 NPPES
Connecticut MEDICAID 008042699

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