Organization
BILL JACOBS LPCC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM JACOBS LPCC (DIRECTOR)
(505) 379-0810
Entity
Organization
Contact information
Practice address
1127 ALAMEDA BLVD NW, SUITE C, ALBUQUERQUE, NM 87114-1240
(505) 379-0810
(505) 890-6806
Mailing address
8608 CLARIDGE PL NW, SUITE C, ALBUQUERQUE, NM 87114-6209
(505) 379-0810
(505) 890-6806
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0065602
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4243782
—
NM
Enumeration date
10/20/2009
Last updated
10/20/2009
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