Edward Jacob

Individual provider Active NPI Social Worker · Frederiksted, VI

NPI 1285232124 · NPPES record last updated Oct 13, 2020

Key facts

NPI
1285232124
Entity type
Individual (NPI type 1)
Primary specialty
Social Worker 104100000X
License
1207 (CT)
Practice address
24X Stoney Ground
Frederiksted, VI 00841
Phone
(917) 569-8303
NPI assigned
Oct 13, 2020
Sex
Male
Sole proprietor
Yes

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)CodeLicenseStatePrimary
Social Worker 104100000X 1207 CT Yes

Addresses

Primary practice location

24X Stoney Ground
Frederiksted, VI 00841

Mailing address

PO Box 392
Frederiksted, VI 00841-0392
Phone (917) 569-8303

Other providers in Frederiksted, VI

All providers in Frederiksted, VI · Social Worker in U.S. Virgin Islands

Sources for this page

Verify at the official NPI Registry.