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James Lloyd Back SR., CDCA
Addiction (Substance Use Disorder) Counselor in Shelby, Ohio
NPI 1144726472

James Lloyd Back SR. is an Addiction (Substance Use Disorder) Counselor based in Shelby, OH and is specialized in Addiction (Substance Use Disorder). James Lloyd Back SR. practices in Shelby, OH and has the professional credentials of CDCA. The NPI Number for James Lloyd Back SR. is 1144726472 and holds a License No. CDCA.981099 (Ohio).

The current practice location address for James Lloyd Back SR. is 2775 State Route 39, Shelby, OH and can be reached out via phone at 419-565-5955.

Location: 2775 State Route 39, Shelby, OH, 44875-9466
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1144726472
Provider Name
James Lloyd Back SR.
Credential
CDCA
Provider Entity Type
Individual
Gender
Male
Address
2775 State Route 39, Shelby, OH, 44875-9466
Phone Number
419-565-5955
Fax Number
Provider Enumeration Date
04/04/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
76-0545741 05 OH
institution
Provider Business Practice Location Address Details
Address
2775 State Route 39
City
Shelby
State
Ohio
Zip
44875-9466
Phone Number
419-565-5955
Fax Number
person
Provider Business Mailing Address Details
Address
2775 State Route 39
City
Shelby
State
Ohio
Zip
44875-9466
Phone Number
419-565-5955
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
CDCA.981099 (Ohio)
Definition
Definition to come...
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