Individual provider · Type 1 NPI

Jacob Israel Ryder, LPC

Professional Counselor · Hampton, VA

NPI number 1104504794 Active

Practice location

200 Medical Dr
Hampton, VA 23666-1763

Call (757) 788-0200 Map

Mailing address

300 Medical Dr
Hampton, VA 23666-1765

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X0701012308 (VA)
Addiction (Substance Use Disorder) Counselor 101YA0400X0710103463 (VA)

Professional Counselor: Definition to come...

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About NPI 1104504794

Jacob Israel Ryder, LPC's National Provider Identifier is 1104504794, issued on Jul 5, 2023. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Hampton, VA. The record was last updated on Jul 5, 2023.