Provider Demographics
NPI:1801569074
Name:JACOBS, LEXY MORGAN (MS)
Entity type:Individual
Prefix:
First Name:LEXY
Middle Name:MORGAN
Last Name:JACOBS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8150 SW 72ND AVE APT 1444
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-7756
Mailing Address - Country:US
Mailing Address - Phone:305-987-2001
Mailing Address - Fax:
Practice Address - Street 1:7800 S RED RD STE 216
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5523
Practice Address - Country:US
Practice Address - Phone:305-662-9162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH21268101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health