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Individual
MELISSA W. JACOB
Active
Individual
MELISSA W. JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
005167
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004247096
—
CT
01
—
140005167CT02
ANTHEM
CT
01
—
279269
MHN
CT
Enumeration date
04/03/2006
Last updated
03/30/2026
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