Provider Demographics
NPI:1366624538
Name:JACOB, CHRISTY FLANNAGIN (MS, LPC, NCC, BCC)
Entity Type:Individual
Prefix:MS
First Name:CHRISTY
Middle Name:FLANNAGIN
Last Name:JACOB
Suffix:
Gender:F
Credentials:MS, LPC, NCC, BCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 2ND AVE SE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-2315
Mailing Address - Country:US
Mailing Address - Phone:256-822-2375
Mailing Address - Fax:256-822-2375
Practice Address - Street 1:113 2ND AVE SE
Practice Address - Street 2:SUITE 4
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-2315
Practice Address - Country:US
Practice Address - Phone:256-822-2375
Practice Address - Fax:256-822-2375
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2542101Y00000X, 101YA0400X, 101YM0800X, 101YP2500X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist