MEDICARE: JACOB STICK MCAP LMHC

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	101YM0800X	Mental Health Counselor	27126	FL

General Provider Information

NPI Number	:	1285573386
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACOB STICK MCAP LMHC

Provider Business Mailing Address
First Line	:	28917 STORMCLOUD PASS
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33543-6429
Country	:	US
Telephone Number	:	813-520-0986
Fax Number	:

Provider Business Practice Location Address
First Line	:	3848 FLATIRON LOOP UNIT 102
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33544-7825
Country	:	US
Telephone Number	:	813-777-3872
Fax Number	:

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

Provider Enumeration Date	:	03/25/2026
Last Update Date	:	03/25/2026

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