Amy Marie Jacobs, LMLP LCP

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

0345 Issued in KS

Practice address

9333 East 21St St., North
Wichita, KS 67206-2927

Phone

(316) 634-4700

Fax

(316) 634-4770

NPI assigned

Nov 18, 2005

Last updated

Jul 8, 2007By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 13, 2013 through Feb 13, 2027

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Paul L. Kurtzweil, PH.D. LLC

  • Clinical Psychologist
  • Wichita, KS
  • NPI 1770802241
  NPD (past)
• Prairie View, Inc.

  • Psychiatry Physician
  • Newton, KS
  • NPI 1558426486
  NPD (past)
• Prairie View, Inc.

  • Psychiatric Hospital
  • Wichita, KS
  • NPI 1902251655
  NPD (past)

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154303659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9333 EAST 21ST ST., NORTH",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672062927",
            "telephone_number": "316-634-4700",
            "fax_number": "316-634-4770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9333 EAST 21ST ST., NORTH",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672062927",
            "telephone_number": "316-634-4700",
            "fax_number": "316-634-4770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "credential": "LMLP LCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "KS",
            "license": "0345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn Ian Jackson, MD
• Jacob Kresky LLC
• Constance Jacob, APRN
• Joel Jacob, MD
• Nathan Jacobberger
• Belinda J Jacobs, LMSW
• Brandon Joel Jacobs, TLMFT
• Chad E Jacobs, LAC
• Kelsey Jacobs
• Leah Jo Jacobs

• Cognitive & Behavioral Psychologist in Wichita, KS
• Providers in Wichita, KS by specialty
• Cognitive & Behavioral Psychologist in Kansas

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.