Individual
ELISA JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
655 E JERSEY ST, YOUTH CASE MANAGEMENT, ELIZABETH, NJ 07206-1259
(908) 994-7380
(908) 994-7322
Mailing address
655 E JERSEY ST, YOUTH CASE MANAGEMENT, ELIZABETH, NJ 07206-1259
(908) 994-7380
(908) 994-7322
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SC04855600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0023302
—
NJ
Enumeration date
01/18/2007
Last updated
07/09/2007
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