Individual
ALEXANDRA D. JACOBUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
360 9TH ST, BROOKLYN, NY 11215-4008
(718) 768-6839
(718) 768-0998
Mailing address
360 9TH ST, BROOKLYN, NY 11215-4008
(718) 768-6839
(718) 768-0998
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
071630
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P2739151
OXFORD
NY
Enumeration date
11/14/2006
Last updated
07/08/2007
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