Individual
STEPHANIE JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC, PH.D.
Contact information
Practice address
1 N BROADWAY, WHITE PLAINS, NY 10601-2310
(914) 385-1150
Mailing address
1 GUSTAVE L LEVY PL, NEW YORK, NY 10029-6500
(212) 659-9299
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
004724
NY
103T00000X
Psychologist
Primary
021934
NY
Other
Enumeration date
08/12/2011
Last updated
03/17/2018
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