Provider Demographics
NPI:1205129566
Name:JOSLIN, JACOB PALMER (LISW)
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:PALMER
Last Name:JOSLIN
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1522 MORGAN ST
Mailing Address - Street 2:
Mailing Address - City:KEOKUK
Mailing Address - State:IA
Mailing Address - Zip Code:52632-4028
Mailing Address - Country:US
Mailing Address - Phone:435-459-3620
Mailing Address - Fax:
Practice Address - Street 1:1522 MORGAN ST
Practice Address - Street 2:
Practice Address - City:KEOKUK
Practice Address - State:IA
Practice Address - Zip Code:52632-4028
Practice Address - Country:US
Practice Address - Phone:319-214-0286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-19
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1016951041C0700X
UT7987783-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical