Provider Demographics
NPI:1245954734
Name:JACOBS, KAILA
Entity type:Individual
Prefix:
First Name:KAILA
Middle Name:
Last Name:JACOBS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27600 CHARDON RD
Mailing Address - Street 2:APT 452
Mailing Address - City:WILLOUGHBY HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44092
Mailing Address - Country:US
Mailing Address - Phone:216-409-2797
Mailing Address - Fax:
Practice Address - Street 1:21625 CHAGRIN BLVD STE 250
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5335
Practice Address - Country:US
Practice Address - Phone:440-343-8069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker