Individual
HEIDI JOAN JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LMHC M-CAP, LCPC
Contact information
Practice address
10 MARKET PLACE DR, YORK, ME 03909-1680
(603) 960-4185
Mailing address
10 MARKET PLACE DR, YORK, ME 03909-1680
(603) 960-4185
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
4968
FL
101YM0800X
Mental Health Counselor
Primary
IMH9011
FL
Other
Enumeration date
06/12/2013
Last updated
07/09/2019
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