Jenessa Jacobsen, RECOVERY ASSISTANT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

301 N Sidney Ave
Russellville, AR 72801-4383

Phone

(479) 890-5494

Fax

(479) 498-9665

NPI assigned

Oct 27, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1445904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1104298447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N SIDNEY AVE",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728014383",
            "telephone_number": "479-890-5494",
            "fax_number": "479-498-9665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N SIDNEY AVE",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728014383",
            "telephone_number": "479-890-5494",
            "fax_number": "479-498-9665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "JENESSA",
        "credential": "RECOVERY ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-27",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "AR",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caydee Ivey
• Julian Wade Ivy, OT
• Rebecca Iwanski, CASE MANAGER CARE CO
• Rosalyn Eloise-Nadine Jackson, LPC
• Whitney Jackson, LPC
• James H. Taylor D.C.PA
• Maggie James, PHD
• Jessica Jarman
• Courtney Jefferson
• Jennifer Harris, Aprn, LLC

• Behavior Technician in Russellville, AR
• Providers in Russellville, AR by specialty
• Behavior Technician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2023; 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.