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Contact Information

JASEN F JACOBSEN
2508 SE 20TH ST
BENTONVILLE, AR72712-4008
 Phone: 479-273-9088
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Addiction (Substance Use Disorder)

101YA0400X
 

Social Worker

104100000X
Indicates primary specialty

NPI Profile & details for JASEN F JACOBSEN · (Male)

NPI # 1659746618
Status Active
Credentials
Entity Individual
Enumeration date 12/02/2015
Last updated 01/30/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • AR License # 12323-M
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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