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General NPI Number Information
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NPI Number | 1467027649
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Entity Type | Individual
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Provider Name | JAKOB MAUER LICSW, LCSW
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Gender | Male
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Dates
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Enumeration Date | 05/20/2021
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Last Update Date | 01/23/2023
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Provider Practice Location Address
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Address Line | 1070 W HORIZON RIDGE PKWY STE 210
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City | HENDERSON
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State | NV
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Zip | 89012-6020
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Country | US
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Telephone | 702-405-0904
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Fax |
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Provider Business Mailing Address
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Address Line | 10650 DEAN MARTIN DR UNIT 412
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City | LAS VEGAS
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State | NV
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Zip | 89141-3589
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Country | US
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Telephone | 406-396-5168
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 9244-S
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License Number State | NV
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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 | 29066
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 10450-C
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License Number State | NV
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