Allysa Jacobson

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

8967 Issued in MN

Practice address

3366 Oakdale Ave N
Robbinsdale, MN 55422-2948

Phone

(763) 581-5372

NPI assigned

Jan 30, 2022

Last updated

Feb 13, 2023By the provider in NPPES

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 MN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Healthwise Psychology PAGroup PAC ID 2567685647, 32 clinicians

Family Innovations IncGroup PAC ID 6204178528, 96 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.allysajacobson@149810.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Innovations, Inc.

  dba LifeStance Health

  • Counseling Psychologist
  • Anoka, MN
  • NPI 1992862783

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Healthwise Psychology, PA

  • Clinical Psychologist
  • Maple Grove, MN
  • NPI 1184920753
  Medicare reassignment Care Compare group NPD
• Scott M Yarosh, LLC

  • Mental Health Counselor
  • Saint Paul, MN
  • NPI 1144543265
  NPD (past)
• West Central Counseling LLC

  • Mental Health Counselor
  • Alexandria, MN
  • NPI 1649846650
  NPD (past)

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

{
    "created_epoch": "1643500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1033862107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 OAKDALE AVE N",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222926",
            "telephone_number": "763-520-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3366 OAKDALE AVE N",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222948",
            "telephone_number": "763-581-5372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "ALLYSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-30",
        "last_updated": "2023-02-13",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "8967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tana Isaacson
• Sadie Ann Iverson, ANP
• Sharon Rose Iverson, PT
• Kathleen Marie Jablonski, CNS
• Courtney Jacobsen
• Scot H. Jaenicke, A.T.C.
• Nilesh Jambhekar, M.D.
• Katherine Jancik, DC
• Scott Jenkins, MD
• Rachael Jensen, ATC

• Psychiatric/Mental Health Nurse Practitioner in Robbinsdale, MN
• Providers in Robbinsdale, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; 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.