Active NPI
Alissa Driscoll Jacobs
- School Social Worker
- Pontiac, MI
National Provider Identifier
1033368147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Social Worker
- Practice address
- 114 Orchard Lake Rd
Pontiac, MI 48341-2244 - Phone
- (248) 858-7766
- Fax
- (248) 858-7201
- NPI assigned
- Sep 12, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | Primary |
Addresses
Primary practice location
114 Orchard Lake Rd
Pontiac, MI 48341-2244
Mailing address
114 Orchard Lake Rd
Pontiac, MI 48341-2244
Phone (248) 858-7766
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1883825 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221177600000",
"number": "1033368147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "114 ORCHARD LAKE RD",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483412244",
"telephone_number": "248-858-7766",
"fax_number": "248-858-7201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 ORCHARD LAKE RD",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483412244",
"telephone_number": "248-858-7766",
"fax_number": "248-858-7201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "ALISSA",
"middle_name": "DRISCOLL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-12",
"last_updated": "2008-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1883825",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pontiac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.