Dr Mary E Jacobsen, PSYD is a
Psychologist - Clinical based in Winston Salem, North Carolina. Dr Mary E Jacobsen is licensed to practice in Virginia (license number 0810003296) and her current practice location is
2594 Reynolda Rd, Suite D, Winston Salem, North Carolina. She can be reached at her office (for appointments etc.) via phone at
(336) 671-6021.
NPI number for Dr Mary E Jacobsen is 1245435759 and her current mailing address is 4220 Redwing Cir, Winston Salem, North Carolina. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1245435759.
Healthcare Provider's Profile
| Full Name | Dr Mary E Jacobsen |
|---|
| Gender | Female |
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| Speciality | Psychologist - Clinical |
|---|
| Location | 2594 Reynolda Rd, Winston Salem, North Carolina |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1245435759
- Provider Enumeration Date: 06/15/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Dr Mary E Jacobsen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1245435759 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | 5110 (North Carolina) | Primary |
| 103T00000X | Psychologist | MN3087 (Minnesota) | Primary |
| 103TC0700X | Psychologist - Clinical | 0810003296 (Virginia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mary E Jacobsen is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Mary E Jacobsen, PSYD
4220 Redwing Cir,
Winston Salem, NC 27106-4273
Ph: (336) 922-7152 | Dr Mary E Jacobsen, PSYD
2594 Reynolda Rd, Suite D,
Winston Salem, NC 27106-4601
Ph: (336) 671-6021 |
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