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Individual
SCOTT C. JACOBS
Active
Individual
SCOTT C. JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
14382
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
80534
PRESBYTERIAN COMMERCIAL
NM
05
—
80534
—
NM
01
—
82938L
BC/BS
TX
01
—
84333Z
HMO BLUE
TX
01
—
A463
TRIWEST
—
Enumeration date
06/27/2005
Last updated
07/09/2007
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