Provider Demographics
NPI:1669024881
Name:ESTEP, JACK CHRISTOPHER (LCDC III)
Entity Type:Individual
Prefix:
First Name:JACK
Middle Name:CHRISTOPHER
Last Name:ESTEP
Suffix:
Gender:M
Credentials:LCDC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 S PAINT ST
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-3202
Mailing Address - Country:US
Mailing Address - Phone:740-571-4424
Mailing Address - Fax:
Practice Address - Street 1:20 S PAINT ST
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-3202
Practice Address - Country:US
Practice Address - Phone:740-571-4424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)