| Elise Jaacobi, Lcsw | |
|
7100 West Camino Real Suite 302 Boca Raton FL 33433-5510 | |
| (561) 212-4343 | |
| Not Available |
| Full Name | Elise Jaacobi, Lcsw |
|---|---|
| Speciality | Social Worker |
| Location | 7100 West Camino Real, Boca Raton, Florida |
| Authorized Official Name and Position | Elise R Jaacobi (OWNER) |
| Authorized Official Contact | 5612124343 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elise Jaacobi, Lcsw 21331 Rockledge Ln Boca Raton FL 33428-4878 Ph: (561) 212-4343 | Elise Jaacobi, Lcsw 7100 West Camino Real Suite 302 Boca Raton FL 33433-5510 Ph: (561) 212-4343 |
| NPI Number | 1245863240 |
|---|---|
| Provider Enumeration Date | 02/18/2020 |
| Last Update Date | 04/14/2020 |
| Certification Date | 04/14/2020 |
| Medicare PECOS PAC ID | 2062842107 |
|---|---|
| Medicare Enrollment ID | O20200414000687 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245863240 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Elise R Jaacobi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689220071 PECOS PAC ID: 9032441761 Enrollment ID: I20191030002406 |
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