Provider Demographics
NPI:1801389978
Name:JACOBS, ALICIA NICOLE (LPC/MHSP)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:NICOLE
Last Name:JACOBS
Suffix:
Gender:F
Credentials:LPC/MHSP
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:NICOLE
Other - Last Name:PITTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC/MHSP
Mailing Address - Street 1:275 CUMBERLAND BND
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1419 KENSINGTON SQUARE CT
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-6939
Practice Address - Country:US
Practice Address - Phone:866-816-0433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4283101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional