Heather Annette Jacoby, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW018280 Issued in PA

Practice address

850 W Lancaster Ave Ste 2
Bryn Mawr, PA 19010-3220

Phone

(610) 520-1510

Fax

(610) 520-1517

NPI assigned

Sep 19, 2014

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

Enrolled in PA

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 1

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Moore Psychological Services LLCGroup PAC ID 0648415646, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Moore Psychological Services, LLC

  • Clinical Psychologist
  • Springfield, PA
  • NPI 1164769543
  Medicare reassignment Care Compare group
• Resources for Human Development, Inc.

  dba LMCMS Peer Support

  • Community/Behavioral Health Agency
  • Bryn Mawr, PA
  • NPI 1548395585
  Medicare reassignment NPD
• Family Practice & Counseling Services Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1689357782
  NPD
• Family Practice & Counseling Services Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1043204811
  NPD (past)

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

{
    "created_epoch": "1411084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411084800000",
    "number": "1174925358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 W LANCASTER AVE STE 2",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103220",
            "telephone_number": "610-520-1510",
            "fax_number": "610-520-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W LANCASTER AVE STE 2",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103220",
            "telephone_number": "610-520-1510",
            "fax_number": "610-520-1517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBY",
        "first_name": "HEATHER",
        "middle_name": "ANNETTE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-19",
        "last_updated": "2014-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW018280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack L. Martin, M.D., P.a.
• Tyler Jackson, MS, LAT, ATC
• Zita Elizabeth Jackson, DO
• Carly Jacobs, DMD
• Serena E.S. Jacobs, LCSW
• James H. Jacoby, M.D.
• Stephen C Jaffe, M.D.
• Lukasz Jakimiec, DO
• Yujin Jang
• Kerry Janson, MA

• Clinical Social Worker in Bryn Mawr, PA
• Providers in Bryn Mawr, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.