Provider Demographics
NPI:1437184561
Name:JACOBS, LINDSAY RAE (LMHC)
Entity Type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:RAE
Last Name:JACOBS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MRS
Other - First Name:LINDSAY
Other - Middle Name:RAE
Other - Last Name:BRANTLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:1565 STATE STREET
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236
Mailing Address - Country:US
Mailing Address - Phone:941-927-8900
Mailing Address - Fax:941-917-1189
Practice Address - Street 1:12497 TAMIAMI TRAIL
Practice Address - Street 2:STE. 4
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34287
Practice Address - Country:US
Practice Address - Phone:941-492-4300
Practice Address - Fax:941-492-2170
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8564101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health