Provider Demographics
NPI:1518552611
Name:VOLKERT, JAY W (CADC)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:W
Last Name:VOLKERT
Suffix:
Gender:M
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 WHITEHALL RD
Mailing Address - Street 2:
Mailing Address - City:MACKVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40040-7027
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1119 WHITEHALL RD
Practice Address - Street 2:
Practice Address - City:MACKVILLE
Practice Address - State:KY
Practice Address - Zip Code:40040-7027
Practice Address - Country:US
Practice Address - Phone:502-861-6661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)