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Individual

DONNA WITHEE JACOBS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
260 PARK ST, GREAT BARRINGTON, MA 01230-1139
(413) 353-0027
(413) 353-0027
Mailing address
260 PARK ST, GREAT BARRINGTON, MA 01230-1139
(413) 353-0027
(413) 353-0027

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
117190
MA
1041C0700X
Clinical Social Worker
R018814
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0050800
GHI - GROUP HEALTH INC.
NY
01
144811
VALUE OPTIONS
NY
01
P407545
OXFORD
NY
Enumeration date
01/20/2007
Last updated
10/30/2012
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