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Individual

MRS. JESSICA ANN JACOBSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.ED., LPC

Contact information

Practice address
302 TOM HALL ST, SUITE 5, FORT MILL, SC 29715-2338
(803) 701-0075
Mailing address
968 ROCK FOREST WAY, INDIAN LAND, SC 29707-4509
(803) 701-0075

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
Primary
5624
SC
101YP2500X
Professional Counselor
9517
NC

Other

Enumeration date
07/08/2010
Last updated
01/16/2016
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