Donna Withee Jacobs, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

117190 Issued in MA

Practice address

260 Park St
Great Barrington, MA 01230-1139

Phone

(413) 353-0027

Fax

(413) 353-0027

NPI assigned

Jan 20, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351555200000",
    "number": "1003969064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 PARK ST",
            "city": "GREAT BARRINGTON",
            "state": "MA",
            "postal_code": "012301139",
            "telephone_number": "413-353-0027",
            "fax_number": "413-353-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 PARK ST",
            "city": "GREAT BARRINGTON",
            "state": "MA",
            "postal_code": "012301139",
            "telephone_number": "413-353-0027",
            "fax_number": "413-353-0027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "DONNA",
        "middle_name": "WITHEE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-20",
        "last_updated": "2012-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R018814",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "117190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI - GROUP HEALTH INC.",
            "identifier": "0050800",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P407545",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "144811",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sarah Jackson, MFA, MA, LP
• William Bradley Jackson, PTA
• Jay B Kain Physical Therapy
• Amy Jenter
• Gregory W Johns, RPH
• Jonathan Nacht DMD PC
• Nina Jones

• All providers in Great Barrington, MA
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.