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Individual

JACOB PRESTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4025 RAWLINS ST, CHEYENNE, WY 82001-1900
(307) 426-4797
Mailing address
4025 RAWLINS ST, CHEYENNE, WY 82001-1900
(307) 426-4797

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
PCSW-1305
WY
171M00000X
Case Manager/Care Coordinator
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1305
CLINICAL SOCIAL WORK PROVISIONAL LICENSE NUMBER
WY
Enumeration date
05/21/2026
Last updated
07/14/2026
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