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Individual

ELYSE MERRICK JACOBSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC, LAC

Contact information

Practice address
155 INVERNESS DR W, ENGLEWOOD, CO 80112-5095
(303) 768-7548
Mailing address
155 INVERNESS DR W, ENGLEWOOD, CO 80112-5095
(303) 768-7548

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
137
CO
101YP2500X
Professional Counselor
Primary
4231
CO

Other

Enumeration date
11/04/2015
Last updated
11/04/2015
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