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General NPI Number Information
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NPI Number | 1912382763
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Entity Type | Individual
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Provider Name | SHARI JACOBS LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/22/2015
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Last Update Date | 08/16/2021
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Provider Practice Location Address
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Address Line | 276 5TH AVE # 704-1938
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City | NEW YORK
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State | NY
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Zip | 10001-4509
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Country | US
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Telephone | 929-279-3950
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Fax |
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Provider Business Mailing Address
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Address Line | 1550 LARIMER ST # 186
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City | DENVER
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State | CO
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Zip | 80202-1602
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Country | US
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Telephone |
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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 | CSW.09926687
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 087441
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License Number State | NY
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