Individual
JACOB HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC-MHSP-S, LPCC-S
Contact information
Practice address
5217 MARYLAND WAY STE 307, BRENTWOOD, TN 37027-1056
(615) 882-1792
Mailing address
3312 COBBLE ST, NASHVILLE, TN 37211-7912
(502) 396-9125
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
12106
OK
101YM0800X
Mental Health Counselor
279920
KY
101YM0800X
Mental Health Counselor
3595
TN
101YM0800X
Mental Health Counselor
6401224036
MI
101YP2500X
Professional Counselor
Primary
3595
TN
Other
Enumeration date
09/28/2016
Last updated
04/18/2024
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