Jacobson, Diana J
Jacobson, Diana J is an individual health care provider with primary practice located at 50 Piermont Ave , Nyack NY 10960. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Jacobson, Diana J can be contacted via phone (845) 353-8322.Contact Information
Primary practice address
50 Piermont Ave
Nyack NY 10960
Phone: (845) 353-8322
Fax: (845) 353-8341
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | R018103 | New York |
Profile Details
| NPI number | 1770652596 |
|---|---|
| LBN Legal business name | Jacobson, Diana J |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 7th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770652596 | NPPES |
| New York | MEDICAID | 01758754 | |
| New York | Other | R018103 |
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