Provider Demographics
NPI:1225720089
Name:HOLLANDER, JACOB PATRICK (LMSW)
Entity Type:Individual
Prefix:MR
First Name:JACOB
Middle Name:PATRICK
Last Name:HOLLANDER
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6010 EXECUTIVE BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3822
Mailing Address - Country:US
Mailing Address - Phone:240-447-7772
Mailing Address - Fax:
Practice Address - Street 1:6010 EXECUTIVE BLVD STE 206
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3822
Practice Address - Country:US
Practice Address - Phone:240-447-7772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29955104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker