Jacob, Mark
Jacob, Mark is an individual health care provider with primary practice located at 251 Johnston St Se Ste 100 , Decatur AL 35601-2515. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Jacob, Mark can be contacted via phone (256) 822-2375.Contact Information
Primary practice address
251 Johnston St Se Ste 100
Decatur AL 35601-2515
Phone: (256) 822-2375
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 1081C | Alabama |
Profile Details
| NPI number | 1245285295 |
|---|---|
| LBN Legal business name | Jacob, Mark |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 24th, 2006 |
| Last updated | Jan 25th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245285295 | NPPES |
| Alabama | Other | 51522567 | BCBS |
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