Barry Lewis Jacobson, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

WA PY00003474 Issued in WA

Practice address

1230 7TH Ave
Longview, WA 98632-3166

Phone

(360) 575-4801

NPI assigned

Oct 26, 2006

Last updated

Jul 8, 2007By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124103551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "497 NEIL BAY DR",
            "city": "FRIDAY HARBOR",
            "state": "WA",
            "postal_code": "982509157",
            "telephone_number": "360-378-1983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 7TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323166",
            "telephone_number": "360-575-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "BARRY",
        "middle_name": "LEWIS",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "WA PY00003474",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "OR 582",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yazan Jaber, D.D.S
• Carmella Jabusch, BA, AAC
• Judy Jabusch, SLPA
• Alicia Jackson, M.A., C.M.H.S.
• Julia Jacobs
• Mary G Jacskon
• Sanjeev Jain, M.D.; PHD
• Miranda Jaksha, SUDP-T
• James L Boylon MD PS
• Rochalle Irene James

• Clinical Psychologist in Longview, WA
• Providers in Longview, WA by specialty
• Clinical Psychologist in Washington

• 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.