Provider Demographics
NPI:1326233420
Name:JACOBUS, LINDA MARGARET (LMFT)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:MARGARET
Last Name:JACOBUS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 EMU ST
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04032-6037
Mailing Address - Country:US
Mailing Address - Phone:714-404-2878
Mailing Address - Fax:
Practice Address - Street 1:273 MAIN ST
Practice Address - Street 2:
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-6753
Practice Address - Country:US
Practice Address - Phone:207-846-0404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 43982106H00000X
CA9101YP2500X
MEMF3924106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional