Christina Jacobs, LMSW
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Clarksdale, MS
NPI 1104302835 · NPPES record last updated Jul 16, 2018
Key facts
- NPI
- 1104302835
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- Practice address
- 1742 Cheryl St
Clarksdale, MS 38614-7218 - Phone
- (662) 627-7267
- Fax
- (662) 627-5240
- NPI assigned
- Jul 16, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MS | ||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | MS | Yes |
Addresses
Primary practice location
1742 Cheryl St
Clarksdale, MS 38614-7218
Mailing address
PO Box 1046
Clarksdale, MS 38614-1046
Phone (662) 627-7267
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- Hunter B Nelson MD PC
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- James Wilkes Bradham Inc
- Ina Jemerson
- Melanie Johnson
- Robin Johnson
- Shana Johnson
All providers in Clarksdale, MS · Addiction (Substance Use Disorder) Counselor in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2018. 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.