Provider Demographics
NPI:1679505929
Name:JAKOBSSON, NANCY N (LCSW)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:N
Last Name:JAKOBSSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:J
Other - Last Name:NESHEIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:305 CARPENTER RD
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-4248
Mailing Address - Country:US
Mailing Address - Phone:970-292-2371
Mailing Address - Fax:970-292-1085
Practice Address - Street 1:305 CARPENTER RD
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-4248
Practice Address - Country:US
Practice Address - Phone:970-292-2371
Practice Address - Fax:970-292-1085
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO991101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO531417COOtherVALUE OPTIONS - COLORADO MEDICAID BEHAVIORAL HEALTH
CO531417COOtherVALUE OPTIONS - COLORADO MEDICAID BEHAVIORAL HEALTH