Individual provider · Type 1 NPI

Jacob Morris Taback, LCSWA

Clinical Social Worker · Charlotte, NC

NPI number 1447170618 Active

Practice location

5007 Providence Rd Ste 105
Charlotte, NC 28226-5907

Call (704) 364-6594 Map

Fax (704) 364-6596

Mailing address

4015 Craft St
Charlotte, NC 28217-1651

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XP024054 (NC)

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 1447170618

Jacob Morris Taback, LCSWA's National Provider Identifier is 1447170618, issued on Jul 17, 2026. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Charlotte, NC. The record was last updated on Jul 17, 2026.