Provider Demographics
NPI:1801469978
Name:LAUREL ANNE JACOBS, LCSW, LLC
Entity type:Organization
Organization Name:LAUREL ANNE JACOBS, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LCSW
Authorized Official - Prefix:
Authorized Official - First Name:LAUREL
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:912-452-0604
Mailing Address - Street 1:PO BOX 13053
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31416-0053
Mailing Address - Country:US
Mailing Address - Phone:912-452-0604
Mailing Address - Fax:844-927-4520
Practice Address - Street 1:109 W BOLTON ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401-6371
Practice Address - Country:US
Practice Address - Phone:912-452-0604
Practice Address - Fax:844-927-4520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty