Provider Demographics
NPI:1851449342
Name:JACOBER, KATHLEEN M (MSW)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:M
Last Name:JACOBER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 E 29TH ST
Mailing Address - Street 2:SUITE225
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-7804
Mailing Address - Country:US
Mailing Address - Phone:970-667-2272
Mailing Address - Fax:970-663-5603
Practice Address - Street 1:150 E 29TH ST
Practice Address - Street 2:SUITE225
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-7804
Practice Address - Country:US
Practice Address - Phone:970-667-2272
Practice Address - Fax:970-663-5603
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9891551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical