Provider Demographics
NPI:1073552337
Name:JACOBS-WHITE, KAREN MICHELLE (LPCC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:MICHELLE
Last Name:JACOBS-WHITE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:JACOBS-AHJUDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC
Mailing Address - Street 1:10 OCONEE WOODS TRL
Mailing Address - Street 2:
Mailing Address - City:SHARPSBURG
Mailing Address - State:GA
Mailing Address - Zip Code:30277-4611
Mailing Address - Country:US
Mailing Address - Phone:470-662-0045
Mailing Address - Fax:
Practice Address - Street 1:10 OCONEE WOODS TRL
Practice Address - Street 2:
Practice Address - City:SHARPSBURG
Practice Address - State:GA
Practice Address - Zip Code:30277-4611
Practice Address - Country:US
Practice Address - Phone:470-662-0045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-0179101YP2500X
GALPC012587101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY341177OtherTRICARE
KY000000338947OtherANTHEM