Elizabeth Lamerial Jacobson, PHD

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH11528 Issued in FL

Practice address

4725 New Broad St
Orlando, FL 32814-6427

Phone

(407) 687-9465

NPI assigned

Jan 5, 2010

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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.

• Impower, Inc

  • Community/Behavioral Health Agency
  • Longwood, FL
  • NPI 1104910868
  NPD (past)
• Intervention Services Inc.

  • Counselor
  • Maitland, FL
  • NPI 1083946297
  NPD (past)

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

{
    "created_epoch": "1262649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1104156785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4725 NEW BROAD ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328146427",
            "telephone_number": "407-687-9465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4725 NEW BROAD ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328146427",
            "telephone_number": "407-687-9465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "ELIZABETH",
        "middle_name": "LAMERIAL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-05",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH11528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Owen Field Jacobs, MSW
• Shawauna Jacobs
• Shenitta N Jacobs
• Tonya Tanisha Jacobs, APRN, FNP-C
• Kristina Jacobsen, ARNP
• Marisa Jacobson
• Ramonita Jacome
• Jacqueson Jacotin
• Jordany Jacotin, MD
• Gardine Jacques, ARNP

• Mental Health Counselor in Orlando, FL
• Providers in Orlando, FL by specialty
• Mental Health Counselor in Florida

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