Individual provider · Type 1 NPI

Lavonne Jacobson, CSAC

Addiction (Substance Use Disorder) Counselor · Shawano, WI

NPI number 1104017953 Active

Practice location

504 Lakeland Rd
Shawano, WI 54166-3836

Fax (715) 526-5542

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed
Mental Health Counselor 101YM0800XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1104017953

Lavonne Jacobson, CSAC's National Provider Identifier is 1104017953, issued on Aug 7, 2007. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Shawano, WI. The record was last updated on Jan 15, 2014.