Provider Demographics
NPI:1982618062
Name:FERNANDEZ-JACOBS, MANUEL FEIJOO (LCSW)
Entity Type:Individual
Prefix:MR
First Name:MANUEL
Middle Name:FEIJOO
Last Name:FERNANDEZ-JACOBS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 MILAN AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-3552
Mailing Address - Country:US
Mailing Address - Phone:305-443-3466
Mailing Address - Fax:305-270-2959
Practice Address - Street 1:7344 SW 48TH ST
Practice Address - Street 2:SUITE #302
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-5546
Practice Address - Country:US
Practice Address - Phone:305-663-0013
Practice Address - Fax:305-663-8138
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 77841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical