| Howard A Jacobson Phd Pc | |
|
1025 Verdae Blvd Suite A Greenville SC 29607-4032 | |
| (864) 546-7315 | |
| Not Available |
| Full Name | Howard A Jacobson Phd Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1025 Verdae Blvd, Greenville, South Carolina |
| Authorized Official Name and Position | Howard A Jacobson (PRESIDENT) |
| Authorized Official Contact | 8645467315 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Howard A Jacobson Phd Pc 1025 Verdae Blvd Suite A Greenville SC 29607-4032 Ph: (864) 546-7315 | Howard A Jacobson Phd Pc 1025 Verdae Blvd Suite A Greenville SC 29607-4032 Ph: (864) 546-7315 |
| NPI Number | 1932373511 |
|---|---|
| Provider Enumeration Date | 04/15/2008 |
| Last Update Date | 01/04/2010 |
| Medicare PECOS PAC ID | 4981742525 |
|---|---|
| Medicare Enrollment ID | O20091119000034 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932373511 | NPI | - | NPPES |
| 3682434 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 1110 (South Carolina) | Primary |
| Provider Name | Howard A Jacobson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366453110 PECOS PAC ID: 7113944034 Enrollment ID: I20091119000030 |
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