Jacobson, Michele

Jacobson, Michele is an individual health care provider with primary practice located at 420 Se 18Th Street , Fort Lauderdale FL 33316. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Jacobson, Michele can be contacted via phone (954) 522-4749.

Contact Information

Primary practice address
420 Se 18Th Street Fort Lauderdale FL 33316
Phone: (954) 522-4749
Fax: (954) 497-3857
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1295863801
LBN Legal business name Jacobson, Michele
Credentials L.M.H.C.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 2nd, 2007
Last updated Jan 13th, 2015 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295863801 NPPES
Florida MEDICAID 768055400

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