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General NPI Number Information
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NPI Number | 1326233420
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Entity Type | Individual
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Provider Name | LINDA MARGARET JACOBUS LMFT
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Gender | Female
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Dates
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Enumeration Date | 09/11/2007
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Last Update Date | 10/24/2012
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Provider Practice Location Address
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Address Line | 273 MAIN ST
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City | YARMOUTH
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State | ME
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Zip | 04096-6753
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Country | US
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Telephone | 207-846-0404
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Fax |
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Provider Business Mailing Address
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Address Line | 24 EMU ST
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City | FREEPORT
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State | ME
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Zip | 04032-6037
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Country | US
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Telephone | 714-404-2878
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC 43982
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 9
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MF3924
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License Number State | ME
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