Provider Demographics
NPI:1891534111
Name:JACOB, MAEGHAN FIELDS (LCSW-BACS, OSW-C)
Entity type:Individual
Prefix:MRS
First Name:MAEGHAN
Middle Name:FIELDS
Last Name:JACOB
Suffix:
Gender:F
Credentials:LCSW-BACS, OSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4728 NEYREY DR
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-1425
Mailing Address - Country:US
Mailing Address - Phone:225-485-4179
Mailing Address - Fax:
Practice Address - Street 1:1203 S TYLER ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-2353
Practice Address - Country:US
Practice Address - Phone:985-875-5325
Practice Address - Fax:985-871-1447
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-24
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA138971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical