Provider Demographics
NPI:1972584662
Name:JACOBS, JAMES FRANKLIN (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:FRANKLIN
Last Name:JACOBS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10807 STERLING COVE DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23838-5247
Mailing Address - Country:US
Mailing Address - Phone:804-586-7017
Mailing Address - Fax:804-748-9517
Practice Address - Street 1:211 N 5TH AVE
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:VA
Practice Address - Zip Code:23860-2509
Practice Address - Country:US
Practice Address - Phone:804-586-7017
Practice Address - Fax:804-748-9517
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0717000722106H00000X
WALF00000856106H00000X
TX004765106H00000X
VA0718000210101YA0400X
TX14421101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional