NPI 1154921799 · live from the CMS NPI Registry
Jacob M Bounds, MSW, LGSW
Social Worker, Clinical in South Charleston, WV. National Provider Identifier 1154921799, active.
NPI record
| NPI | 1154921799 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 1109 Jefferson Rd Ste C, South Charleston, WV 25309 |
| Practice phone | 877-338-2725 |
| Mailing address | 1234 Stone Rd Apt A, Charleston, WV 25314 |
| Enumerated | October 30, 2020 |
| Last updated | February 1, 2021 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist, Addiction (Substance Use Disorder) | 103TA0400X | — |
| Social Worker, Clinical | 1041C0700X | SW062015550 (WV) |
| Social Worker, Clinical primary | 1041C0700X | BP00945821 (WV) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.