Kyle Adam Jacobsen, LCSW
Individual provider Active NPI Clinical Social Worker · White Sulphur Springs, MT
NPI 1033655253 · NPPES record last updated Mar 24, 2022
Key facts
- NPI
- 1033655253
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Practice address
- 209 S Central Ave RM 304
White Sulphur Springs, MT 59645-9086 - Phone
- (406) 640-3242
- NPI assigned
- Jan 11, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ponderosa Counseling and Therapeutic Services, LLC | Clinical | Current |
Accepting new patients |
Locations
119 W Park St
Ste 5
Livingston, MT 59047
Phone (406) 220-6204
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Yes |
Addresses
Primary practice location
209 S Central Ave RM 304
White Sulphur Springs, MT 59645-9086
Mailing address
PO Box 802
White Sulphur Springs, MT 59645-1802
Phone (406) 640-3242
Other providers in White Sulphur Springs, MT
- Jennifer Lee Brunsdon
- Castle Mountain Drug PLLC
- Caley Clark
- Ronald Hamm
- Jennifer Jones Hurwitz
- McKenzie Lin Johnson
- Meagher County Ambulance
- Meagher County Health Department
- David S Meissner
- Mountainview Medical Center
All providers in White Sulphur Springs, MT · Clinical Social Worker in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.