Individual
CAROLYN M JACOBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4850 S THOMPSON AVE, TACOMA, WA 98408
(941) 600-6656
Mailing address
4850 S THOMPSON AVE, TACOMA, WA 98408-5733
(941) 600-6656
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW60614321
WA
1041C0700X
Clinical Social Worker
SW11574
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LW60614321
LICSW
WA
01
—
SW11574
LCSW
FL
Enumeration date
06/30/2015
Last updated
07/26/2018
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