MEDICARE: MS. JACQUELINE K BECK-JACOBSON LMHP, CPC

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	101YP2500X	Professional Counselor	1617	NE
2	101YP2500X	Professional Counselor	0022230	CO
3	101YM0800X	Mental Health Counselor	3115	NE

General Provider Information

NPI Number	:	1780883124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JACQUELINE K BECK-JACOBSON LMHP, CPC

Provider Business Mailing Address
First Line	:	2315 N 60TH AVE
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68104-4009
Country	:	US
Telephone Number	:	402-770-9417
Fax Number	:

Provider Business Practice Location Address
First Line	:	2315 N 60TH AVE
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68104-4009
Country	:	US
Telephone Number	:	402-770-9417
Fax Number	:

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

Provider Enumeration Date	:	07/16/2007
Last Update Date	:	06/03/2025

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