Gary Michael Jacobson, LCSW, CASAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R034699-1 Issued in NY

Practice address

7 Prospect St
New Paltz, NY 12561-1137

Phone

(845) 256-2220

Fax

(845) 255-9211

NPI assigned

Nov 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073692695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WALNUT LN",
            "city": "ROSENDALE",
            "state": "NY",
            "postal_code": "124729734",
            "telephone_number": "845-658-3606",
            "fax_number": "845-658-3606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 PROSPECT ST",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125611137",
            "telephone_number": "845-256-2220",
            "fax_number": "845-255-9211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "GARY",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "LCSW, CASAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R034699-1",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "ME266469",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CASAC",
            "identifier": "4491",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAINE CLINICAL SOCIAL WOR",
            "identifier": "ME266469",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "R034699-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raana Irfan
• Samantha Jane Irvine, M.S.
• It'S a Girl Thing Counseling Amy Frisch LCSW, PLLC
• Robert Jacobsen, DPT
• Amy C. Jacobson, LCSW-R
• Jaikumar Ravunniarath Medical P.C.
• Anna Aurora Jakubek, FNP-BC
• Shannon H James, RPH
• Richard M Janof, DC
• Jansen Road Nursing and Rehabilitation Center LLC

• Clinical Social Worker in New Paltz, NY
• Providers in New Paltz, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.