MEDICARE: MR. JOSEPH ELDON JACOBSON JR. 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	2008007498	MO

General Provider Information

NPI Number	:	1720259724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSEPH ELDON JACOBSON JR. LCSW

Provider Business Mailing Address
First Line	:	309 N VERMONT ST
Second Line	:
City	:	SUGAR CREEK
State	:	MO
Zip	:	64054-1256
Country	:	US
Telephone Number	:	816-935-6768
Fax Number	:	816-776-6423

Provider Business Practice Location Address
First Line	:	811 S BUSINESS HIGHWAY 13
Second Line	:
City	:	LEXINGTON
State	:	MO
Zip	:	64067-1515
Country	:	US
Telephone Number	:	877-344-3572
Fax Number	:	866-228-4492

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

Provider Enumeration Date	:	03/18/2008
Last Update Date	:	08/06/2025

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