Provider Demographics
NPI:1841381308
Name:LOUISE JACOBS, P.C.
Entity Type:Organization
Organization Name:LOUISE JACOBS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:402-463-9355
Mailing Address - Street 1:PO BOX 174
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68902-0174
Mailing Address - Country:US
Mailing Address - Phone:402-463-9355
Mailing Address - Fax:402-463-9354
Practice Address - Street 1:440 N MINNESOTA AVE
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-5254
Practice Address - Country:US
Practice Address - Phone:402-463-9355
Practice Address - Fax:402-463-9354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025358700Medicaid
NE10025358700Medicaid