Individual
MR. BRADLEY JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
385 TREMONT AVE, EAST ORANGE, NJ 07018-1023
(973) 676-1000
Mailing address
42 HERBERT TER, WEST ORANGE, NJ 07052-1076
(917) 697-2687
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
085502
NY
Other
Enumeration date
03/01/2021
Last updated
03/02/2021
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