Individual provider · Type 1 NPI
Kenneth Vincent Bascom Jr., MA
Addiction (Substance Use Disorder) Counselor · Honesdale, PA
NPI number
1861048159
Active
Practice location
1855 Fair Ave
Honesdale, PA 18431-2121
Fax (570) 253-3982
Mailing address
151 Warner Rd
North Branch, NY 12766-5045
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 647010 (PA) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
Another provider at this address
About NPI 1861048159
Kenneth Vincent Bascom Jr., MA's National Provider Identifier is 1861048159, issued on Aug 13, 2019. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Honesdale, PA. The record was last updated on Aug 13, 2019.