Provider Demographics
NPI:1982153284
Name:JACOBSSON, ANNALIESE (LICSW, MSW, BSW)
Entity type:Individual
Prefix:
First Name:ANNALIESE
Middle Name:
Last Name:JACOBSSON
Suffix:
Gender:F
Credentials:LICSW, MSW, BSW
Other - Prefix:
Other - First Name:ANNALIESE
Other - Middle Name:
Other - Last Name:ARMSTRONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSW
Mailing Address - Street 1:7191 WAGNER WAY STE 304
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-6909
Mailing Address - Country:US
Mailing Address - Phone:253-468-7899
Mailing Address - Fax:
Practice Address - Street 1:7191 WAGNER WAY STE 304
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-6909
Practice Address - Country:US
Practice Address - Phone:253-468-7899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-27
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LW612584721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical