JACOB B GILMORE LCDC III
NPI 1396397527
Counselor - Addiction (Substance Use Disorder) in Warren, OH

Active since July 09, 2019
4930 ENTERPRISE DR NW, WARREN, OH 44481(330) 787-0955 Get Directions Write a Review

NPPES record last updated: March 7, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 7, 2025, Jul 9, 2019 (2 updates tracked since 2019).

About Jacob B Gilmore Lcdc Iii NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACOB B GILMORE LCDC III (NPI 1396397527) is an individual addiction (substance use disorder) provider in Warren, Ohio, licensed in Ohio (LCDCIII162380) and active in the NPI registry since July 2019. He maintains a secondary practice location in Warren.

NPPES Registry Identity

NPI1396397527
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameJACOB B GILMORECredential: LCDC III
Location Address4930 ENTERPRISE DR NWWarren, OH 44481-8706
Mailing Address4930 Enterprise Dr NwWarren, OH 44481-8706 · (330) 787-0955
Sole ProprietorYes
Enumeration DateJuly 9, 2019
Last NPPES UpdateMarch 7, 20252 updates tracked since enumeration
NPPES CertifiedMarch 7, 2025
NPI 1396397527 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License Licensed in OH · LCDCIII162380
Also ListedSubstance Abuse Rehabilitation FacilityTaxonomy 324500000X · License 170920 (OH)
4930 ENTERPRISE DR NW, Warren, OH 44481

Secondary Practice Location 1

Location 12737 Youngstown Rd SEWarren, OH 44484-5002 · Phone (330) 369-8022 ext. 153

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Licensed Practical Nurse
4930 ENTERPRISE DR NW
WARREN, OH 44481
Substance Abuse Rehabilitation Facility
4930 ENTERPRISE DR NW
WARREN, OH 44481
Substance Abuse Rehabilitation Facility
4930 ENTERPRISE DR NW
WARREN, OH 44481
Social Worker
4930 ENTERPRISE DR NW
WARREN, OH 44481
Licensed Practical Nurse
4930 ENTERPRISE DR NW
WARREN, OH 44481
Substance Abuse Rehabilitation Facility
4930 ENTERPRISE DR NW
WARREN, OH 44481
Counselor (Addiction (Substance Use Disorder))
4930 ENTERPRISE DR NW
WARREN, OH 44481
Counselor (Addiction (Substance Use Disorder))
4930 ENTERPRISE DR NW
WARREN, OH 44481

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Gilmore's NPI number?

The NPI number for Jacob Gilmore is 1396397527. It was assigned to this individual provider in the NPPES registry on July 9, 2019.

Where is Jacob Gilmore located?

Jacob Gilmore practices at 4930 Enterprise Dr NW, Warren, OH 44481. The listed phone number is (330) 787-0955.

What is Jacob Gilmore's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Jacob Gilmore was last updated on March 7, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.