MRS. LILLIE MARIE JACOBS LCSW NPI 1750332540

NPI Information

NPI: 1750332540
Provider Name: MRS. LILLIE MARIE JACOBS, LCSW
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

PECOS Registration: Yes

Address:
3125 EASTWAY DRIVE
SUITE 109
CHARLOTTE, NC
ZIP 28205
Phone: (704) 566-9437
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MRS. Lillie Marie Jacobs, LCSW is a mental health counselor in Charlotte, NC with 39 years of experience. MRS. Lillie Marie Jacobs, LCSW NPI is 1750332540. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3125 EASTWAY DRIVE
SUITE 109
CHARLOTTE, NC
ZIP 28205
Phone: (704) 566-9437
Fax: (704) 566-9437

The NPI 1750332540 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 5/15/2006 and was last updated on 11/10/2021.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	C002751	NORTH CAROLINA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	555280	OTHER		VALUE OPTIONS
2	13318	OTHER	NORTH CAROLINA	BLUE CROSS BLUE SHIELD
3	262210	OTHER		COMP PSYCH
4	026940	OTHER		VMC BEHAVIORAL
5	3077B1531	OTHER		MEDCOST
6	6002517	MEDICAID	NORTH CAROLINA
7	QMXTR0029414	OTHER		MENTAL HEALTH NETWORK

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: 5/5/2024

NPI Synchronization or Removal

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