Individual provider · Type 1 NPI
Jonathan Jacobs, LPC, LADC-C
Professional Counselor · Fairland, OK
NPI number
1700476785
Active
Practice location
59801 E Highway 60
Fairland, OK 74343-2019
Mailing address
59805 E Highway 60
Fairland, OK 74343-2019
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | 11775 (OK) |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1501 (OK) |
| Mental Health Counselor | 101YM0800X | 11775 (OK) |
Professional Counselor: Definition to come...
About NPI 1700476785
Jonathan Jacobs, LPC, LADC-C's National Provider Identifier is 1700476785, issued on Jan 22, 2021. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Fairland, OK. The record was last updated on Jan 27, 2026.