Individual
JAYNE SAMANTHA JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC, MA-ED, MSCO-MH
Contact information
Practice address
55 BUCKBOARD DR, NORWOOD, CO 81423-5006
(970) 596-2856
Mailing address
PO BOX 298, NORWOOD, CO 81423-0298
(970) 596-2856
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPCC.0021465
CO
101YM0800X
Mental Health Counselor
LPCC.0021465
CO
101YP2500X
Professional Counselor
LPCC.0021465
CO
Other
Enumeration date
12/29/2023
Last updated
12/29/2023
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