JARRAD MICHAEL THACKER CDCA.173952
NPI 1457940736
Counselor - Addiction (Substance Use Disorder) in Cincinnati, OH

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).

Active since January 12, 2021

4968 GLENWAY AVE, CINCINNATI, OH 45238(513) 853-6575 Get Directions Write a Review

NPPES record last updated: January 12, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Jarrad Michael Thacker Cdca.173952 NPPES

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

JARRAD MICHAEL THACKER CDCA.173952 (NPI 1457940736) is an individual addiction (substance use disorder) provider in Cincinnati, Ohio, licensed in Ohio (CDCA.173952) and active in the NPI registry since January 2021.

NPPES Registry Identity

NPI1457940736

Entity TypeIndividualMale

Primary Taxonomy101YA0400X

Provider Legal NameJARRAD MICHAEL THACKERCredential: CDCA.173952

Location Address4968 GLENWAY AVECincinnati, OH 45238-3902

Mailing Address1494 Beacon St Apt 3Cincinnati, OH 45230-2857 · (513) 314-0708

Phone(513) 853-6575

Sole ProprietorNo

Enumeration DateJanuary 12, 2021

NPPES CertifiedJanuary 12, 2021

✔ NPI 1457940736 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

License✔ Licensed in OH · CDCA.173952

4968 GLENWAY AVE, Cincinnati, OH 45238

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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.

DR. DOUGLAS DAVID MOLL PSY.D.

Psychologist

4968 GLENWAY AVE, 2ND FLOOR
CINCINNATI, OH 45238

Hamilton County (513) 557-2810

MARY E KINSELLA LPCC

Counselor (Professional)