Jacobs, Lillie Marie

Jacobs, Lillie Marie is an individual health care provider with primary practice located at 3125 Eastway Drive Suite 109, Charlotte NC 28205. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Jacobs, Lillie Marie can be contacted via phone (704) 566-9437.

Contact Information

Primary practice address
3125 Eastway Drive Suite 109 Charlotte NC 28205
Phone: (704) 566-9437
Fax: (704) 566-9437
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X C002751 North Carolina

Profile Details

NPI number 1750332540
LBN Legal business name Jacobs, Lillie Marie
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date May 15th, 2006
Last updated Nov 10th, 2021 - about 3 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750332540 NPPES
North Carolina Other 13318 BLUE CROSS BLUE SHIELD
North Carolina Other 3077B1531 BLUE CROSS BLUE SHIELD
North Carolina Other 026940 BLUE CROSS BLUE SHIELD
North Carolina Other 555280 BLUE CROSS BLUE SHIELD
North Carolina Other QMXTR0029414 BLUE CROSS BLUE SHIELD
North Carolina Other 262210 BLUE CROSS BLUE SHIELD
North Carolina MEDICAID 6002517 BLUE CROSS BLUE SHIELD

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