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Individual
JERROLD JACOBSON
Active
Individual
JERROLD JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA CAP LMHC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2389
FL
101YM0800X
Mental Health Counselor
MH 4420
FL
103K00000X
Behavior Analyst
Primary
1-01-0707
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
676127596
—
FL
05
—
676127598
—
FL
Enumeration date
12/31/2010
Last updated
12/31/2010
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