Ellen H Jacobs, MSW, LISW, DCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

I0000217 Issued in OH

Practice address

145 W 46TH St
Ashtabula, OH 44004-6916

Phone

(440) 998-7541

Fax

(440) 997-4282

NPI assigned

Jan 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pbc.ellenjacobs@140094.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Psychological & Behavioral Consultants, LLC

  dba LifeStance Health

  • Psychiatry Physician
  • Beachwood, OH
  • NPI 1811915713
  Medicare reassignment NPD
• North Shore Psychological Services LTD

  • Psychologist
  • Ashtabula, OH
  • NPI 1487636965
  NPD (past)
• Riverside Counseling Associates, Inc.

  • Clinical Psychologist
  • Ashtabula, OH
  • NPI 1528102654
  NPD (past)

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292803200000",
    "number": "1033199419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 W 46TH ST",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440046916",
            "telephone_number": "440-998-7541",
            "fax_number": "440-997-4282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 W 46TH ST",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440046916",
            "telephone_number": "440-998-7541",
            "fax_number": "440-997-4282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "ELLEN",
        "middle_name": "H",
        "name_prefix": "Mrs.",
        "credential": "MSW, LISW, DCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-20",
        "last_updated": "2010-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I0000217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casey Iverson
• Charlene J. Jackson, PT
• Robin Suzette Jackson
• Travis Carson Jackson
• Vanessa Micheline Jackson
• Maureen Denise Jacobson, R.D. , L.D.
• Nathaniel Alton Janezic
• Amber Jarvis
• Hilda S Jarvis, SPECIALIST
• Carla Javorich, CDCA

• Social Worker in Ashtabula, OH
• Providers in Ashtabula, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.