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NPI Code Detail

MEDICARE: JACOB C ROBBINS

MEDICARE: JACOB C ROBBINS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor88002800AIN

General Provider Information

NPI Number : 1164386637
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACOB C ROBBINS
Provider Business Mailing Address
First Line : 2330 DEERWOOD DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-3914
Country : US
Telephone Number : 260-432-0066
Fax Number :
Provider Business Practice Location Address
First Line : 6202 CONSTITUTION DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-1583
Country : US
Telephone Number : 260-432-0066
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2025
Last Update Date : 12/10/2025

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Directions to “ JACOB C ROBBINS ” Practice Location

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