Provider Demographics
NPI:1043835929
Name:JACOBSON COUNSELING, HEALTH & WELLNESS CONSULTING, LLC
Entity type:Organization
Organization Name:JACOBSON COUNSELING, HEALTH & WELLNESS CONSULTING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRINCIPLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBSON
Authorized Official - Suffix:
Authorized Official - Credentials:DBH, LPCC-S
Authorized Official - Phone:513-206-3026
Mailing Address - Street 1:120 MARKET PLACE CIR STE C-182
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-7205
Mailing Address - Country:US
Mailing Address - Phone:513-206-3026
Mailing Address - Fax:513-620-5642
Practice Address - Street 1:108 CHICKADEE TRL
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-2105
Practice Address - Country:US
Practice Address - Phone:513-206-3026
Practice Address - Fax:513-620-5642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-16
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty