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NPI Code Detail

MEDICARE: AMY E JACOBS MSW

MEDICARE: AMY E JACOBS MSW
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
11041S0200XSchool Social Worker070368-1NY
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1518020197
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY E JACOBS MSW
Provider Business Mailing Address
First Line : 200 N 7TH STREET
Second Line :
City : LEBANON
State : PA
Zip : 17046-5040
Country : US
Telephone Number : 717-273-1710
Fax Number : 717-273-1416
Provider Business Practice Location Address
First Line : 1 GREYSTONE ROAD
Second Line :
City : CARLISLE
State : PA
Zip : 17013-2660
Country : US
Telephone Number : 717-243-7534
Fax Number : 717-243-5489
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2006
Last Update Date : 02/09/2010

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