Tammy Demetrius Jacobs, LMHC, LPC, MA,

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C8286 Issued in OR

Practice address

503 Covil Ave Ste 102
Wilmington, NC 28403-2683

Phone

(910) 202-4270

NPI assigned

Dec 10, 2013

Last updated

Oct 17, 2024By 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 5

Addresses

Medicare fee-for-service enrollment

Enrolled in OR, NC2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  NC, OR

  Medicare reassignment NPD
• Giving Hope Deaf Counseling Center, LLC.

  • Community/Behavioral Health Agency
  • Birmingham, AL
  • NPI 1588518476
  NPD Authorized official

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

{
    "created_epoch": "1386633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1114358660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4369 MILNER RD W",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352427355",
            "telephone_number": "646-655-0475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 COVIL AVE STE 102",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032683",
            "telephone_number": "910-202-4270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "TAMMY",
        "middle_name": "DEMETRIUS",
        "credential": "LMHC, LPC, MA,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-10",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LGP11355",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C8286",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AL",
            "license": "LPC05181",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "14816",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "12852525-6009",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob's Business Ventures (A Loyal Home Care)
• Cheyanne Nevaeh Jacobs
• Lila G Jacobs
• Mariah Jacobs
• Shiletter Jacobs, CD
• Barbara Jacques, LMFTA
• Audrey Rose Jaenicke, LCSWA
• Walker Jackman Jamar, PA
• Tiffany Jamerson, CFM, CFTS
• James a Gainer DDS

• Mental Health Counselor in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; 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.