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General NPI Number Information
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NPI Number | 1538838073
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Entity Type | Organization
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Legal Business Name | ISAAC JACOBS, LCSW, PLLC
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Dates
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Enumeration Date | 09/08/2021
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Last Update Date | 09/08/2021
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Provider Practice Location Address
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Address Line | 36 WINTHROP ST
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City | ROCHESTER
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State | NY
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Zip | 14607-1326
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Country | US
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Telephone | 585-314-8083
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Fax | 585-623-8182
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Provider Business Mailing Address
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Address Line | 36 WINTHROP ST
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City | ROCHESTER
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State | NY
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Zip | 14607-1326
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Country | US
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Telephone | 585-314-8083
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Fax | 585-623-8182
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Authorized Official
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Title or Position | LCSW-OWNER
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Name | MR. ISAAC JACOBS
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Credential | LCSW
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Telephone | 585-314-8083
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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