Provider Demographics
NPI:1558068668
Name:JACOBS, BATSHEVA (MS MFTC)
Entity Type:Individual
Prefix:
First Name:BATSHEVA
Middle Name:
Last Name:JACOBS
Suffix:
Gender:F
Credentials:MS MFTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4770 S XANTHIA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-2951
Mailing Address - Country:US
Mailing Address - Phone:650-815-8727
Mailing Address - Fax:
Practice Address - Street 1:13693 E ILIFF AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-6527
Practice Address - Country:US
Practice Address - Phone:720-788-0302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-09
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0014291106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist