MEDICARE: MARK JACOB LCSW

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
1	1041C0700X	Clinical Social Worker	1081C	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	51522567	OTHER	AL	BCBS

General Provider Information

NPI Number	:	1245285295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK JACOB LCSW

Provider Business Mailing Address
First Line	:	16 MOULTON ST E
Second Line	:
City	:	DECATUR
State	:	AL
Zip	:	35601-2310
Country	:	US
Telephone Number	:	256-822-2375
Fax Number	:

Provider Business Practice Location Address
First Line	:	251 JOHNSTON ST SE STE 100
Second Line	:
City	:	DECATUR
State	:	AL
Zip	:	35601-2515
Country	:	US
Telephone Number	:	256-822-2375
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	01/25/2023

Similar Medicare Providers

1003819608 — ENCORE REHABILITATION, INC
Practice Location Address:

251 JOHNSTON ST , SUITE 300
DECATUR, AL
35601-2515

Practice Phone: 256-340-9708
Practice Fax: 256-340-9624

1295111557 — COVENANT COUNSELING & CONSULTING LLC
Practice Location Address:

251 JOHNSTON ST SE STE 100
DECATUR, AL
35601-2515

Practice Phone: 256-822-2375
Practice Fax: 256-584-2330

1356841332 — REBECCA MARIE DAVIS
Practice Location Address:

251 JOHNSTON ST SE STE 200
DECATUR, AL
35601-2515

Practice Phone: 125-635-0176
Practice Fax: 256-350-1764

1922661255 — HAYLEY RABBIT
Practice Location Address:

251 JOHNSTON ST SE STE 200
DECATUR, AL
35601-2515

Practice Phone: 256-350-1764
Practice Fax:

1770205940 — MRS. ANNA MONROE SCHAUER LICSW-PIP
Practice Location Address:

251 JOHNSTON ST SE STE 100
DECATUR, AL
35601-2515

Practice Phone: 256-822-2375
Practice Fax:

1598742405 — MARK WILLIAM FEEMAN D.O.
Practice Location Address:

2785 LAWRENCEVILLE HWY STE 100
DECATUR, GA
30033-2515

Practice Phone: 404-659-5909
Practice Fax: 770-399-9449

Directions to “ MARK JACOB LCSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.