Individual
MS. JAMIE L JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHP, CPC, LPC, LADC
Contact information
Practice address
400 SYCAMORE LN, APT 208, WOODSTOCK, GA 30188-7315
(404) 663-0597
Mailing address
409 CHATEAU DR SE, T-2, ROME, GA 30161-6616
(404) 663-0597
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
537
NE
101YM0800X
Mental Health Counselor
2297
NE
101YP2500X
Professional Counselor
Primary
005516
GA
101YP2500X
Professional Counselor
1276
NE
Other
Enumeration date
07/14/2006
Last updated
02/16/2015
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