Active NPI
Gail Jean Jacobs, LCSW
- Clinical Social Worker
- Minden, NV
National Provider Identifier
1053590760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 17533
- Practice address
- 1650 Hwy 395 Suite 202C
Minden, NV 89423 - Phone
- (775) 781-9916
- Fax
- (775) 265-1841
- NPI assigned
- Oct 30, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 17533 | CA | Primary |
Addresses
Primary practice location
1650 Hwy 395 Suite 202C
Minden, NV 89423
Mailing address
660 Stones Throw Rd
Gardnerville, NV 89410-7809
Phone (775) 781-9916
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7800-C | Other | NV | LCSW |
| 17533 | Other | CA | LCSW |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17533 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581897600000",
"number": "1053590760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "660 STONES THROW RD",
"city": "GARDNERVILLE",
"state": "NV",
"postal_code": "894107809",
"telephone_number": "775-781-9916"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 HWY 395 SUITE 202C",
"city": "MINDEN",
"state": "NV",
"postal_code": "89423",
"telephone_number": "775-781-9916",
"fax_number": "775-265-1841"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "GAIL",
"middle_name": "JEAN",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-10-30",
"last_updated": "2020-02-17",
"certification_date": "2020-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "17533",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCSW",
"identifier": "7800-C",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCSW",
"identifier": "17533",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minden, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.