Individual
MS. CAROLYN DIANE JACOBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
853 BROADWAY, SUITE 701, NEW YORK, NY 10003-4703
(212) 979-7576
Mailing address
853 BROADWAY, SUITE 701, NEW YORK, NY 10003-4703
(212) 979-7576
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R057691-1
NY
Other
Enumeration date
12/11/2006
Last updated
07/08/2007
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