Provider Demographics
NPI:1427315159
Name:JACOBI, SHALANA (LPC-S)
Entity type:Individual
Prefix:
First Name:SHALANA
Middle Name:
Last Name:JACOBI
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7909 AVENUE M
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-7314
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4810 N COUNTY ROAD 2800
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79403-7297
Practice Address - Country:US
Practice Address - Phone:806-687-6301
Practice Address - Fax:806-747-3193
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66394101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional