Provider Demographics
NPI:1851509368
Name:JAKOVICS, GEORGE SCOTT (LCPC , LCADC)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:SCOTT
Last Name:JAKOVICS
Suffix:
Gender:M
Credentials:LCPC , LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 SYCAMORE RD
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-3634
Mailing Address - Country:US
Mailing Address - Phone:410-647-8717
Mailing Address - Fax:410-793-5510
Practice Address - Street 1:1831 FOREST DR STE D
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-4430
Practice Address - Country:US
Practice Address - Phone:410-279-3174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCA340101YA0400X
MDLCO979101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional