Provider Demographics
NPI:1871259655
Name:SEAMONS, JACOB (MS, BCBA)
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:
Last Name:SEAMONS
Suffix:
Gender:M
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 WASHINGTON BLVD APT 1
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-6364
Mailing Address - Country:US
Mailing Address - Phone:234-407-7143
Mailing Address - Fax:
Practice Address - Street 1:5500 MARKET ST STE 118
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-2616
Practice Address - Country:US
Practice Address - Phone:330-991-9117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-16
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No171M00000XOther Service ProvidersCase Manager/Care Coordinator