Provider Demographics
NPI:1134589807
Name:DRAKE, JEFFREY EDWARD (LPCC)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:EDWARD
Last Name:DRAKE
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 1:544 RILEY AVE
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-3087
Mailing Address - Country:US
Mailing Address - Phone:614-906-8505
Mailing Address - Fax:
Practice Address - Street 1:544 RILEY AVE
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-3087
Practice Address - Country:US
Practice Address - Phone:614-906-8505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-24
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2203119101YP2500X
OHC.1000369101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor