=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730089442
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SABRINA JACONSKI LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/06/2026
-----------------------------------------------------
Last Update Date | 11/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 696 SECOND STREET PIKE STE 101
-----------------------------------------------------
City | RICHBORO
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18954-1068
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-354-7700
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3 W COURT ST APT 3
-----------------------------------------------------
City | DOYLESTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18901-4244
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | PC021166
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------