| Brian Jacobs, Licensed Clinical Social Worker, Pc | |
|
339 S Main St Sebastopol CA 95472-4208 | |
| (707) 829-5474 | |
| Not Available |
| Full Name | Brian Jacobs, Licensed Clinical Social Worker, Pc |
|---|---|
| Speciality | Counselor |
| Location | 339 S Main St, Sebastopol, California |
| Authorized Official Name and Position | Brian Jacobs (OWNER) |
| Authorized Official Contact | 7078295474 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brian Jacobs, Licensed Clinical Social Worker, Pc 339 S Main St Sebastopol CA 95472-4208 Ph: (707) 829-5474 | Brian Jacobs, Licensed Clinical Social Worker, Pc 339 S Main St Sebastopol CA 95472-4208 Ph: (707) 829-5474 |
| NPI Number | 1417712456 |
|---|---|
| Provider Enumeration Date | 02/19/2024 |
| Last Update Date | 02/19/2024 |
| Certification Date | 02/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417712456 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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