MEDICARE: NATALIE JACEWICZ M.ED

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

General Provider Information

NPI Number	:	1386578151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE JACEWICZ M.ED

Provider Business Mailing Address
First Line	:	2040 EBINPORT RD
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-1291
Country	:	US
Telephone Number	:	908-514-7495
Fax Number	:

Provider Business Practice Location Address
First Line	:	2040 EBINPORT RD
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-1291
Country	:	US
Telephone Number	:	908-514-7495
Fax Number	:

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

Provider Enumeration Date	:	06/09/2026
Last Update Date	:	06/09/2026

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