Healthcare Provider Details

I. General information

NPI: 1285573386
Provider Name (Legal Business Name): JACOB STICK MCAP LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3848 FLATIRON LOOP UNIT 102
WESLEY CHAPEL FL
33544-7825
US

IV. Provider business mailing address

28917 STORMCLOUD PASS
WESLEY CHAPEL FL
33543-6429
US

V. Phone/Fax

Practice location:
  • Phone: 813-777-3872
  • Fax:
Mailing address:
  • Phone: 813-520-0986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number27126
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: