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General NPI Number Information
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NPI Number | 1053899195
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Entity Type | Individual
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Provider Name | JACOB KLEIN LCSW
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Gender | Male
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Dates
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Enumeration Date | 07/31/2018
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Last Update Date | 10/24/2023
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Provider Practice Location Address
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Address Line | 70 WOODFIN PL STE 214B
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City | ASHEVILLE
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State | NC
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Zip | 28801-2467
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Country | US
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Telephone | 914-227-0693
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Fax |
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Provider Business Mailing Address
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Address Line | 403 CHARLOTTE ST APT 5
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City | ASHEVILLE
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State | NC
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Zip | 28801-1445
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Country | US
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Telephone | 914-227-0693
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCAS-25197
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C013743
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License Number State | NC
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