Provider Demographics
NPI:1740918804
Name:ORR, JACOB TIMOTHY (LCMHC)
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:TIMOTHY
Last Name:ORR
Suffix:
Gender:M
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 CHARLOTTE HWY STE E
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-8681
Mailing Address - Country:US
Mailing Address - Phone:286-205-7478
Mailing Address - Fax:
Practice Address - Street 1:204 CHARLOTTE HWY STE E
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-8681
Practice Address - Country:US
Practice Address - Phone:828-333-5708
Practice Address - Fax:828-484-1025
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-08
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17656101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health