Provider Demographics
NPI:1720259724
Name:JACOBSON, JOSEPH ELDON JR (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ELDON
Last Name:JACOBSON
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:208 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:MO
Mailing Address - Zip Code:64085-1812
Mailing Address - Country:US
Mailing Address - Phone:816-935-6768
Mailing Address - Fax:816-776-6423
Practice Address - Street 1:212 S CAMDEN ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:MO
Practice Address - Zip Code:64085-1628
Practice Address - Country:US
Practice Address - Phone:816-470-6300
Practice Address - Fax:816-776-6423
Is Sole Proprietor?:No
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20080074981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical