Provider Demographics
NPI:1174783286
Name:JACOBS, SUSAN E (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:E
Last Name:JACOBS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2205 SADDLE RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-5069
Mailing Address - Country:US
Mailing Address - Phone:775-827-0315
Mailing Address - Fax:
Practice Address - Street 1:2205 SADDLE RIDGE CT
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-5069
Practice Address - Country:US
Practice Address - Phone:775-827-0315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2025-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5191-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical