Provider Demographics
NPI:1932350634
Name:JACOBI, CYNTHIA O (LPCC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:O
Last Name:JACOBI
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 N DIXIE HWY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-4649
Mailing Address - Country:US
Mailing Address - Phone:270-505-4183
Mailing Address - Fax:270-900-1238
Practice Address - Street 1:4000 N DIXIE HWY
Practice Address - Street 2:SUITE 2
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-4649
Practice Address - Country:US
Practice Address - Phone:270-505-4183
Practice Address - Fax:270-900-1238
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1465101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional