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General NPI Number Information
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NPI Number | 1710262647
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Entity Type | Individual
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Provider Name | ESTHER SHARON JACOBSON LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/11/2011
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Last Update Date | 07/26/2024
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Provider Practice Location Address
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Address Line | 3710 RICHMOND AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10312-3848
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Country | US
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Telephone | 718-967-0490
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Fax |
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Provider Business Mailing Address
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Address Line | 6 VASSAR ST
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City | STATEN ISLAND
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State | NY
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Zip | 10314-6004
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Country | US
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Telephone | 786-640-3250
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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 | 078761
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License Number State | NY
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