Individual provider · Type 1 NPI

Jacob B. Gilmore, LCDC III

Addiction (Substance Use Disorder) Counselor · Warren, OH

NPI number 1396397527 Active

Practice location

4930 Enterprise Dr NW
Warren, OH 44481-8706

Call (330) 787-0955 Map

Other practice locations

  • 2737 Youngstown Rd SE, Warren, OH 44484-5002 · (330) 369-8022

Specialties and licenses

TaxonomyCodeLicense
Substance Abuse Rehabilitation Facility 324500000X170920 (OH)
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XLCDCIII162380 (OH)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1396397527

Jacob B. Gilmore, LCDC III's National Provider Identifier is 1396397527, issued on Jul 9, 2019. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Warren, OH. The record was last updated on Mar 7, 2025.