Jacob A Defee, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

P1701219 Issued in AR

Practice address

100 W Grove St Ste 302
El Dorado, AR 71730-4669

Phone

(501) 358-6396

Fax

(501) 588-0484

NPI assigned

Jan 18, 2013

Last updated

Dec 18, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Therapy Assessment Center LLCGroup PAC ID 0941538557, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Therapy Assessment Center, LLC

  • Group Psychotherapy Psychologist
  • Conway, AR
  • NPI 1093184210
  Medicare reassignment Care Compare group NPD
• Therapy Assessment Center LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Conway, AR
  • NPI 1487492153
  NPD

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

{
    "created_epoch": "1358467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1063750404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 OAK ST STE 3",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720325679",
            "telephone_number": "501-291-3091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W GROVE ST STE 302",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717304669",
            "telephone_number": "501-358-6396",
            "fax_number": "501-588-0484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "317 Oak St Ste 3",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "AR",
            "postal_code": "720325679",
            "country_code": "US",
            "telephone_number": "501-291-3091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEFEE",
        "first_name": "JACOB",
        "middle_name": "A",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-18",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P1701219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Davis
• Steven Robert Davis, CRNA
• Dayspring Services of Arkansas LLC
• Debra Faulkner (Port X Medical Services)
• Debra Faulkner (Portable Imaging)
• Peggy A Defoure
• Joseph A Deluca, MD
• Richard Edward Dietzen, M.D.
• Rebekah Marie Dixon, LCSW
• Rodney M. Dixon, M.D.

• Professional Counselor in El Dorado, AR
• Providers in El Dorado, AR by specialty
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.