Jacob A Defee, LPC | |
100 W Grove St Ste 302, El Dorado, AR 71730-4669 | |
(501) 358-6396 | |
(501) 588-0484 |
Full Name | Jacob A Defee |
---|---|
Gender | Male |
Speciality | Counselor - Professional |
Location | 100 W Grove St Ste 302, El Dorado, Arkansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1063750404 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | P1701219 (Arkansas) | Primary |
Entity Name | Therapy Assessment Center Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1093184210 PECOS PAC ID: 0941538557 Enrollment ID: O20190821000368 |
Mailing Address | Practice Location Address |
---|---|
Jacob A Defee, LPC 317 Oak St Ste 3, Conway, AR 72032-5679 Ph: (501) 291-3091 | Jacob A Defee, LPC 100 W Grove St Ste 302, El Dorado, AR 71730-4669 Ph: (501) 358-6396 |
Mrs. Patricia S Burks, AT Counselor Medicare: Not Enrolled in Medicare Practice Location: 412 N Washington Ave, El Dorado, AR 71730 Phone: 870-863-4611 Fax: 870-863-4962 | |
T'revah Cobb, Counselor Medicare: Not Enrolled in Medicare Practice Location: 412 N Washington Ave, El Dorado, AR 71730 Phone: 870-863-4611 Fax: 870-741-4784 | |
Miss Judith Anne Jamerson, MHPP Counselor Medicare: Not Enrolled in Medicare Practice Location: 412 N Washington Ave, El Dorado, AR 71730 Phone: 870-863-4611 Fax: 870-863-4962 | |
Katherine Elizabeth Lain, LAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 200 W Main, El Dorado, AR 71730 Phone: 817-565-7089 | |
Kelsey Newton Jones, LAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 214 Archer Ave, El Dorado, AR 71730 Phone: 501-804-9245 | |
Tiffany Hamilton, Counselor Medicare: Not Enrolled in Medicare Practice Location: 412 N Washington Ave, El Dorado, AR 71730 Phone: 870-863-4611 Fax: 870-863-4962 |