Individual provider Active NPI

Maral Jacobs, M.S.

  • Mental Health Counselor
  • Las Vegas, NV
National Provider Identifier
1235545369
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CP0155 Issued in NV
Practice address
2620 Regatta Dr Ste 102
Las Vegas, NV 89128-6892
Phone
(702) 236-0452
NPI assigned
Jul 9, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CP0155 NV Primary

Addresses

Primary practice location

2620 Regatta Dr Ste 102
Las Vegas, NV 89128-6892

Mailing address

2620 Regatta Dr Ste 102
Las Vegas, NV 89128-6892
Phone (702) 236-0452

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
CP0155NVMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1404864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1235545369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 REGATTA DR STE 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891286892",
            "telephone_number": "702-236-0452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 REGATTA DR STE 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891286892",
            "telephone_number": "702-236-0452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "MARAL",
        "name_prefix": "Mrs.",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-09",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NV",
            "license": "CP0155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; 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.