| Doctor Name: | LESLIE ANN JACOBS |
| NPI Number: | 1356494942 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW,LCSW |
| License Number: | 34003274A |
| Business Practice Address: | 1956 Ohio Ave Connersville, IN - 473312858 |
| Business Phone Number: | 7658275610 |
| Business Fax Number: | |
| Mailing Address: | 3892 S Base Rd, CONNERSVILLE |
| State: | IN |
| Postal Code: | 473318979 |
| Phone Number: | 7658253656 |
| Fax Number: | |
| NPI Enumeration Date: | 01/19/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 34003274A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |