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CECILIA JACOBS PSY.D. LLC NPI 1134392814


NPI Information

NPI: 1134392814
Provider Name: CECILIA JACOBS, PSY.D., LLC
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
2188 GATEWAY DR
FAIRBORN, OH
ZIP 45324
Phone: (937) 320-5859
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CECILIA JACOBS, PSY.D., LLC is a community behavioral health in Fairborn, OH. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. CECILIA JACOBS, PSY.D., LLC NPI is 1134392814. The provider is registered as an organization entity type.

The provider's business location address is:

2188 GATEWAY DR
FAIRBORN, OH
ZIP 45324-356
Phone: (937) 320-5859
Fax: (937) 426-1349

The provider's authorized official is Cecilia Jacobs .
The authorized official title is Clinical Psychologist and has the following contact phone number (937) 320-5859.

The enumeration date for this NPI number is 4/2/2008 and was last updated on 4/2/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251S00000XCommunity/Behavioral Health5332OHIOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1CE9357771MEDICARE UPINOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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