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General NPI Number Information
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NPI Number | 1952365363
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Entity Type | Individual
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Provider Name | JACOB MICHAEL NORGAARD LPC, NCC
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Gender | Male
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 05/21/2015
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Provider Practice Location Address
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Address Line | 1901 CENTRAL DR SUITE 602
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City | BEDFORD
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State | TX
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Zip | 76021-5869
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Country | US
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Telephone | 817-523-8222
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Fax | 817-533-3434
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Provider Business Mailing Address
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Address Line | PO BOX 210176
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City | BEDFORD
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State | TX
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Zip | 76095-7176
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Country | US
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Telephone | 817-523-8222
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Fax | 817-533-3434
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 13934
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License Number State | TX
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