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General NPI Number Information
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NPI Number | 1750113734
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Entity Type | Individual
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Provider Name | STEVEN JAKOBOVIC LMSW
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Gender | Male
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Dates
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Enumeration Date | 08/17/2024
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Last Update Date | 08/17/2024
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Provider Practice Location Address
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Address Line | 623 W 34TH ST STE 105
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City | BALTIMORE
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State | MD
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Zip | 21211-2658
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Country | US
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Telephone | 443-873-0635
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Fax |
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Provider Business Mailing Address
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Address Line | 4116 WESTVIEW RD
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City | BALTIMORE
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State | MD
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Zip | 21218-1455
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Country | US
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Telephone | 646-509-1988
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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