Jacob, Kenneth William

Jacob, Kenneth William is an individual health care provider with primary practice located at 680 Park Ave W , Mansfield OH 44906-3706. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Jacob, Kenneth William can be contacted via phone (419) 528-5993.

Contact Information

Primary practice address
680 Park Ave W Mansfield OH 44906-3706
Phone: (419) 528-5993
Fax: (567) 560-5486
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 011389 Ohio
Behavioral Health & Social Service Providers / Clinical 1041C0700X S.0500567 Ohio

Profile Details

NPI number 1174780183
LBN Legal business name Jacob, Kenneth William
Credentials LSW
Entity Individual
Sole proprietor 1 No
Enumeration date May 19th, 2008
Last updated Mar 7th, 2019 - about 5 years 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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