Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Brenda Lavonne Jacob, MS, CCDCIII, LAT

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1780812214

Mrs. Brenda Lavonne Jacob, MS, CCDCIII, LAT is an Addiction (Substance Use Disorder) Counselor in Gillette, Wyoming. Practices as a sole proprietor. Licensed in South Dakota and Wyoming.

Licensed in
SD, WY
In the registry since
2009
Specialties on file
2
What do these letters mean?
MS — Master of Science
A graduate science degree.
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.

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Practice location Address checks out

113 S Gillette Ave
Gillette, WY 82716-3740
Phone: (307) 685-6982
Fax: (307) 685-8054
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence LAT-270 (WY)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 99111065 (SD)

Record details

NPI number1780812214
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS , CCDCIII , LAT
Sole proprietorYes
NPI enumeratedJune 23, 2009
Last updated in NPPESJune 23, 2009

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