Ellen Marie Jacob, LCSW, CDP

Clinical Social Worker · Venice, FL

Individual Active NPI

NPI number 1285415059

Practice location

302 Falls of Venice Cir
Venice, FL 34292-3979
Phone
(904) 607-0160

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NPI record

NPI
1285415059
Entity type
Individual (Type 1)
Enumeration date
October 9, 2023
Last updated
May 28, 2026
Certified
May 28, 2026
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Clinical Social Worker Primary 1041C0700X 24099 FL
Clinical Social Worker 1041C0700X 1881606 ID
Clinical Social Worker 1041C0700X 089.013646161TELE VT

Mailing address

11541 Shady Acres Path
Venice, FL 34293-8140
Phone
(904) 607-0160

About Ellen Jacob

Ellen Marie Jacob, LCSW, CDP is a healthcare provider registered in the NPI registry with the primary taxonomy Clinical Social Worker (code 1041C0700X). The practice location is 302 Falls of Venice Cir, Venice, FL 34292-3979. The NPI number 1285415059 was assigned on October 9, 2023 and the record was last updated on May 28, 2026.

Ellen Jacob lists 3 licenses in the registry: #24099 (FL) for Clinical Social Worker; #1881606 (ID) for Clinical Social Worker; #089.013646161TELE (VT) for Clinical Social Worker. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Ellen Marie Jacob, LCSW, CDP?

The NPI number is 1285415059.

What is the phone number of Ellen Jacob?

The phone number listed for the practice location is (904) 607-0160.

Where is Ellen Jacob located?

302 Falls of Venice Cir, Venice, FL 34292-3979.

What is the taxonomy code for Ellen Jacob?

The primary taxonomy code is 1041C0700X – Clinical Social Worker; 2 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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