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NPI Code Detail

MEDICARE: KAREN G JACOBS MSW LCSWC

MEDICARE: KAREN G JACOBS MSW LCSWC
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
11041C0700XClinical Social Worker05499MD

General Provider Information

NPI Number : 1871715219
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAREN G JACOBS MSW LCSWC
Provider Business Mailing Address
First Line : 328 LISA OAKS WAY
Second Line :
City : ROCKVILLE
State : MD
Zip : 20850-4739
Country : US
Telephone Number : 301-230-5500
Fax Number :
Provider Business Practice Location Address
First Line : 328 LISA OAKS WAY
Second Line :
City : ROCKVILLE
State : MD
Zip : 20850-4739
Country : US
Telephone Number : 301-230-5500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2007
Last Update Date : 07/08/2007

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