Doctor Name: | MR. LARRY KAY JACOBSON |
NPI Number: | 1124127766 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC NCC |
License Number: | 1221526004 |
Business Practice Address: | 3500 Harrison Blvd Suite 105 Ogden, UT - 844032058 |
Business Phone Number: | 8017254422 |
Business Fax Number: | |
Mailing Address: | 440 East 3050 North, NORTH OGDEN |
State: | UT |
Postal Code: | 844141936 |
Phone Number: | 8017828129 |
Fax Number: | |
NPI Enumeration Date: | 09/21/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 1221526004 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |