person
Mr. Kenneth Vincent Bascom JR., MA
Addiction (Substance Use Disorder) Counselor in Honesdale, Pennsylvania
NPI 1861048159

Kenneth Vincent Bascom JR. is an Addiction (Substance Use Disorder) Counselor based in North Branch, PA and is specialized in Addiction (Substance Use Disorder). Kenneth Vincent Bascom JR. practices in Honesdale, PA and has the professional credentials of MA. The NPI Number for Kenneth Vincent Bascom JR. is 1861048159 and holds a License No. 647010 (Pennsylvania).

The current practice location address for Kenneth Vincent Bascom JR. is 1855 Fair Ave, Honesdale, PA and can be reached out via phone at 570-253-3980 and via fax at 570-253-3982.

Location: 1855 Fair Ave, Honesdale, PA, 12766-5045
person
Provider Profile Details
NPI Number
1861048159
Provider Name
Kenneth Vincent Bascom JR.
Credential
MA
Provider Entity Type
Individual
Gender
Male
Address
1855 Fair Ave, Honesdale, PA, 12766-5045
Phone Number
570-253-3980
Fax Number
570-253-3982
Provider Enumeration Date
08/13/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1855 Fair Ave
City
State
Zip
18431-2121
Phone Number
570-253-3980
Fax Number
570-253-3982
person
Provider Business Mailing Address Details
Address
1855 Fair Ave
City
State
Zip
18431-2121
Phone Number
570-253-3980
Fax Number
570-253-3982
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
647010 (Pennsylvania)
Definition
Definition to come...
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