Individual
ABBY JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LCDP
Contact information
Practice address
63 HARMONY HILL RD, CHEPACHET, RI 02814-1429
(401) 949-0690
(401) 949-4412
Mailing address
63 HARMONY HILL RD, CHEPACHET, RI 02814-1429
(401) 949-0690
(401) 949-4412
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
000121
VT
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDP00512
RI
103TA0400X
Addiction (Substance Use Disorder) Psychologist
000121
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2033065
CIGNA
VT
Enumeration date
03/27/2007
Last updated
03/13/2012
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