NPIMap

Organization Active NPI

OBGYN Psychiatry LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Altamonte Springs, FL
National Provider Identifier
1194537969
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
OBGYN PSYCHIATRY LLC
Practice address
200 Maitland Ave Apt 142
Altamonte Springs, FL 32701-5539
Phone
(321) 356-2881
NPI assigned
Jan 21, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Authorized official

Name
Noelle Jacobsen, APRN, PMHNP-CNPI 1942246392
Title
Owner & Pmhnp
Phone
(321) 356-2881

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

200 Maitland Ave Apt 142
Altamonte Springs, FL 32701-5539

Mailing address

200 Maitland Ave Apt 142
Altamonte Springs, FL 32701-5539
Phone (321) 356-2881

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1737417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1194537969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MAITLAND AVE APT 142",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327015539",
            "telephone_number": "321-356-2881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MAITLAND AVE APT 142",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327015539",
            "telephone_number": "321-356-2881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBGYN PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-21",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-20",
        "status": "A",
        "authorized_official_last_name": "JACOBSEN",
        "authorized_official_first_name": "NOELLE",
        "authorized_official_title_or_position": "OWNER & PMHNP",
        "authorized_official_telephone_number": "321-356-2881",
        "authorized_official_credential": "APRN, PMHNP-C"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.