Doctor Name: | MR. JEREMY THOMAS HORN |
NPI Number: | 1487926044 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPCC |
License Number: | LPCPCC00222202 |
Business Practice Address: | 170 Madison Ave Whitesburg, KY - 418587750 |
Business Phone Number: | 6068215475 |
Business Fax Number: | 6066337046 |
Mailing Address: | 79 Tennessee Ave, WHITESBURG |
State: | KY |
Postal Code: | 418587773 |
Phone Number: | 6068215475 |
Fax Number: | 6066337046 |
NPI Enumeration Date: | 01/29/2012 |
NPI Last Update Date: | 05/04/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LPCPCC00222202 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |