Jalissa Ann Jacobs, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SL012367 Issued in PA

Practice address

2481 Sunset LN
York, PA 17408-4205

Phone

(724) 859-7126

NPI assigned

Jul 12, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1255853289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2481 SUNSET LN",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174084205",
            "telephone_number": "724-859-7126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2481 SUNSET LN",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174084205",
            "telephone_number": "724-859-7126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "JALISSA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": "SL012367",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL012367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Jackson, MA, LPC
• Tiffany A Jackson, CNM
• Zena Auset Zechariah Diane Jackson, CADC CCAR, CRPA
• Ron Mathew Jacob, M.D.
• Diane Kay Jacobs
• Aubrey Jacobson, MD
• Melissa A Jacoby, OTR/L
• Jacques L. Surer, Jr., D.O.,PC
• Edith Geraldine Jadick, LCSW
• Sabih Jafri

• Speech-Language Pathologist in York, PA
• Providers in York, PA by specialty
• Speech-Language Pathologist in Pennsylvania

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