Mikaela Jacobson

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

123303 Issued in TX

Practice address

107 S Judy St
Hallettsville, TX 77964-3223

Phone

(361) 210-7366

Fax

(361) 799-5001

NPI assigned

Jan 27, 2025

Last updated

Jan 27, 2025By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Texas Elite Therapy Team LLC

  • Speech-Language Pathologist
  • Hallettsville, TX
  • NPI 1356038947
  NPD

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

{
    "created_epoch": "1737936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1265245195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 166",
            "city": "HALLETTSVILLE",
            "state": "TX",
            "postal_code": "779640166",
            "telephone_number": "361-210-7366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S JUDY ST",
            "city": "HALLETTSVILLE",
            "state": "TX",
            "postal_code": "779643223",
            "telephone_number": "361-210-7366",
            "fax_number": "361-799-5001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 E Airline Rd",
            "address_purpose": "LOCATION",
            "city": "Victoria",
            "state": "TX",
            "postal_code": "779014000",
            "country_code": "US",
            "telephone_number": "361-210-7366",
            "fax_number": "361-799-5001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "711 N Avenue D",
            "address_purpose": "LOCATION",
            "city": "Shiner",
            "state": "TX",
            "postal_code": "779845210",
            "country_code": "US",
            "telephone_number": "361-210-7366",
            "fax_number": "361-799-5001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "109 Shult Dr Ste 202",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "TX",
            "postal_code": "789343015",
            "country_code": "US",
            "telephone_number": "361-210-7366",
            "fax_number": "361-799-5001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "MIKAELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-27",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "123303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jma Pharmacies (Center Pharmacy)
• Ruth C Johnson, P.T.
• Kristi Kaiser, PT
• Traci Lee Kaiser, LCSW
• Cheryl Lynnette Kalmus

• Speech-Language Pathologist in Hallettsville, TX
• Providers in Hallettsville, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.