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General NPI Number Information
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NPI Number | 1932331543
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Entity Type | Individual
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Provider Name | JACOB CURT DURTSCHI LCSW
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Gender | Male
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Dates
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Enumeration Date | 08/14/2009
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 500 W IDAHO ST STE 251
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City | BOISE
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State | ID
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Zip | 83702-5754
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Country | US
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Telephone | 208-890-8391
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Fax |
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Provider Business Mailing Address
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Address Line | 816 1/2 N 10TH ST
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City | BOISE
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State | ID
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Zip | 83702-5422
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Country | US
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Telephone | 208-890-8391
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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 | LCSW-29607
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SC61678823
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License Number State | WA
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