Provider Demographics
NPI:1689173825
Name:COMBS, JEFFREY (LPCC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:COMBS
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1192 PIGEONROOST RD
Mailing Address - Street 2:
Mailing Address - City:BULAN
Mailing Address - State:KY
Mailing Address - Zip Code:41722-9027
Mailing Address - Country:US
Mailing Address - Phone:606-216-5431
Mailing Address - Fax:
Practice Address - Street 1:25 CLYDEAN DR
Practice Address - Street 2:
Practice Address - City:LEBURN
Practice Address - State:KY
Practice Address - Zip Code:41831-8702
Practice Address - Country:US
Practice Address - Phone:606-785-1148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-02
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
KY175315101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health