# COALESCE FAMILY SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972372613
- **Authorized official:** MRS. HAZEL E JACOBS LCSW, LISW-CP (OWNER)
- **Authorized official phone:** (803) 262-7486

## Contact information

- **Practice address:** 1805 CLEMSON RD UNIT 290171, COLUMBIA, SC 29229-0507
- **Practice address phone:** (803) 262-7486
- **Practice address fax:** (843) 459-7987
- **Mailing address:** 10120 TWO NOTCH RD \# 361, COLUMBIA, SC 29223-4395
- **Mailing address phone:** (803) 262-7486
- **Mailing address fax:** (843) 459-7987

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 12/21/2023
- **Last updated:** 08/04/2024