Provider Demographics
NPI:1962421602
Name:HUFFER, JAMES KEITH (LISW)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:KEITH
Last Name:HUFFER
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4861 DICKENS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43227-2140
Mailing Address - Country:US
Mailing Address - Phone:614-861-8573
Mailing Address - Fax:
Practice Address - Street 1:555 W SCHROCK RD STE 220
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8739
Practice Address - Country:US
Practice Address - Phone:614-895-9998
Practice Address - Fax:614-895-9592
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-0002419104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker