Necha Devorah Jacob, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5079-226 Issued in WI

Practice address

2524 E Webster PL
Milwaukee, WI 53211-4256

Phone

(414) 388-5861

NPI assigned

Oct 13, 2021

Last updated

Oct 13, 2021By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

Mental Health Counselor

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakewood Community Services Corp.Group PAC ID 3274952114, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: njacob@thelighthouseclinic.com

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.

• Lakewood Community Services Corp.

  • Community/Behavioral Health Agency
  • Lakewood, NJ
  • NPI 1093085649
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1235891581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3453 N 54TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162801",
            "telephone_number": "414-388-5861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2524 E WEBSTER PL",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532114256",
            "telephone_number": "414-388-5861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "NECHA",
        "middle_name": "DEVORAH",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-13",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5079-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "njacob@thelighthouseclinic.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "direct and healthcare information exchange",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2524 E Webster Pl",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532114256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Vickie Lee Jackson
• Victoria Cassandra Jackson, LCSW
• Vinice Jackson
• Vonte Jackson, DDS
• Jacksonscott2
• Arica Lynn Jacobs, DPT
• Camille Olivia Jacobs
• Dora A. Jacobs, NP
• Elizabeth Jacobs, MD
• Falcon Jacobs

• Professional Counselor in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; 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.