Todd A Jacobson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L2320 Issued in OR

Practice address

58646 McNulty Way
Saint Helens, OR 97051-6210

Phone

(503) 397-5211

Fax

(503) 397-5373

NPI assigned

Dec 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Mid-Columbia Center for Living

  • Community/Behavioral Health Agency
  • The Dalles, OR
  • NPI 1275954513
  NPD (past)
• Mid-Columbia Center for Living

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • The Dalles, OR
  • NPI 1699745794

  Clinical

  NPD (past)
• Mid-Columbia Center for Living

  • Community/Behavioral Health Agency
  • Hood River, OR
  • NPI 1831510155
  NPD (past)

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1053479352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58646 MCNULTY WAY",
            "city": "SAINT HELENS",
            "state": "OR",
            "postal_code": "970516210",
            "telephone_number": "503-397-5211",
            "fax_number": "503-397-5373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58646 MCNULTY WAY",
            "city": "SAINT HELENS",
            "state": "OR",
            "postal_code": "970516210",
            "telephone_number": "503-397-5211",
            "fax_number": "503-397-5373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "TODD",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L2320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139670",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin Matthew Irons
• Rebecca A Izbicki
• Jordan Jackson Sr.
• Lacey Jade Jackson
• Thomas Larue Jacobs, ARNP
• Tyrone James
• Robert Hillman Janz, LPC, QMHP
• Georgia Brenteney Jeffreys
• Lucca Jenkins-Law
• Rebecca Helen Jenkins, M.S.W

• Clinical Social Worker in Saint Helens, OR
• Providers in Saint Helens, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.