Lori Jacobson, LCSW
Individual provider Active NPI Clinical Social Worker · Bunnell, FL
NPI 1871643932 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1871643932
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- SW5119 (FL)
- Practice address
- 103 Bay Street
Bunnell, FL 32137 - Phone
- (386) 864-1744
- NPI assigned
- Jan 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW5119 | FL | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW5119 | FL | Yes |
Addresses
Primary practice location
103 Bay Street
Bunnell, FL 32137
Mailing address
53 Brunswick LN
Palm Coast, FL 32137-3627
Phone (386) 864-1744
Other providers in Bunnell, FL
- Hospitality Oxygen and Medical Equipment, LLC
- Neomi P Howe
- Joy Christine Imbeault
- Integrative Physician Services Inc.
- J C Hall Arnp PA
- Jay Home Medical Equipment Inc
- Lisa Jane Jimenez
- JSC Pedorthics Inc.
- Betty Kachnycz
- Kazaam Services LLC
All providers in Bunnell, FL · Clinical Social Worker in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.