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Organization
OBGYN PSYCHIATRY LLC
Active
Organization
OBGYN PSYCHIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NOELLE JACOBSEN APRN, PMHNP-C (OWNER & PMHNP)
(321) 356-2881
Entity
Organization
Contact information
Practice address
200 MAITLAND AVE APT 142, ALTAMONTE SPRINGS, FL 32701-5539
(321) 356-2881
Mailing address
200 MAITLAND AVE APT 142, ALTAMONTE SPRINGS, FL 32701-5539
(321) 356-2881
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
01/21/2025
Last updated
01/21/2025
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