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General NPI Number Information
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NPI Number | 1891055141
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Entity Type | Organization
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Legal Business Name | JACOBS COUNSELING, INC
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Dates
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Enumeration Date | 05/21/2012
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Last Update Date | 05/21/2012
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Provider Practice Location Address
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Address Line | 3215 KELLER ANDREWS RD
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City | SANFORD
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State | NC
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Zip | 27330-7046
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Country | US
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Telephone | 919-777-3350
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Fax |
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Provider Business Mailing Address
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Address Line | 2019 BEACHWOOD DR
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City | SANFORD
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State | NC
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Zip | 27330-9271
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Country | US
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Telephone | 919-777-3350
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Fax |
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Authorized Official
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Title or Position | THERAPIST/OWNER
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Name | MR. CYNTHIA CAMPBELL JACOBS
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Credential | LPC
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Telephone | 919-777-3350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4891
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License Number State | NC
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