# SHADALE NICOLE JACOBS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1598961542
- **Gender:** F
- **Credential:** MS, LCMHCA

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | A8910 | NC | Yes |
| 101YM0800X | Mental Health Counselor | — | NULL | — |

## Other

- **Enumeration date:** 06/26/2007
- **Last updated:** 02/03/2022