Individual provider · Type 1 NPI
Ellen Marie Jacob, LCSW, CDP
Clinical Social Worker · Venice, FL
Practice location
302 Falls Of Venice Cir
Venice, FL 34292-3979
Mailing address
11541 Shady Acres Path
Venice, FL 34293-8140
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinical Social Worker Primary | 1041C0700X | 24099 (FL) |
| Clinical Social Worker | 1041C0700X | 1881606 (ID) |
| Clinical Social Worker | 1041C0700X | 089.013646161TELE (VT) |
Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…
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About NPI 1285415059
Ellen Marie Jacob, LCSW, CDP's National Provider Identifier is 1285415059, issued on Oct 9, 2023. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Venice, FL. The record was last updated on May 28, 2026.