Individual
DR. MARY E JACOBSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
2594 REYNOLDA RD, SUITE D, WINSTON SALEM, NC 27106-4601
(336) 671-6021
Mailing address
4220 REDWING CIR, WINSTON SALEM, NC 27106-4273
(336) 922-7152
(336) 922-5239
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
5110
NC
103T00000X
Psychologist
MN3087
MN
103TC0700X
Clinical Psychologist
Primary
0810003296
VA
Other
Enumeration date
06/15/2007
Last updated
09/11/2025
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