Provider Demographics
NPI:1366116253
Name:HOWARD, JIMMIE (LSW,CDCA)
Entity type:Individual
Prefix:
First Name:JIMMIE
Middle Name:
Last Name:HOWARD
Suffix:
Gender:M
Credentials:LSW,CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:642 BRITTAIN RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44305-2037
Mailing Address - Country:US
Mailing Address - Phone:330-274-6764
Mailing Address - Fax:
Practice Address - Street 1:642 BRITTAIN RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44305-2037
Practice Address - Country:US
Practice Address - Phone:330-274-6764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty