Liesl Jade Jacobs, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

35.097603 Issued in OH

Practice address

5350 Lamme Rd
Moraine, OH 45439-3215

Phone

(937) 534-4651

Fax

(937) 534-4669

NPI assigned

Jul 12, 2007

Last updated

Sep 29, 2026By 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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/tcn/r4/

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.

• TCN Behavioral Health Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Xenia, OH
  • NPI 1336118256
  Medicare reassignment NPD
• TCN Behavioral Health Services, Inc

  • Psychiatry Physician
  • Fairborn, OH
  • NPI 1770725806
  NPD (past)

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1063611853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PRESTIGE PL",
            "address_2": "SUITE 550",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453423794",
            "telephone_number": "937-752-2310",
            "fax_number": "937-522-8493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5350 LAMME RD",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454393215",
            "telephone_number": "937-534-4651",
            "fax_number": "937-534-4669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "LIESL",
        "middle_name": "JADE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35.097603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "QMP000004762758",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0067987",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000915098",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret Kane Jackovitz
• Kyle Raymond Jackson
• Marry Emma Jackson, QMHS ASSOC
• Elizabeth Anne Jacobs
• Kathryn Jacobs
• Karalina Christine Jamison
• Ashley Jansen, MSW,LSW
• Natalie Nicole Jenkins, LSW
• David Flynn Johnson, LPCC-S
• Hunter Johnson, BA

• Psychiatry Physician in Moraine, OH
• Providers in Moraine, OH by specialty
• Psychiatry Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; 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.