Individual provider Active NPI

Robert L Jacobson, LCSW-C

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1275973570
Registry record updated Feb 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15932 Issued in MD
Practice address
2418 Sylvale Rd
Baltimore, MD 21209-1539
Phone
(410) 493-2473
NPI assigned
Jul 1, 2013
Last updated
Feb 4, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 15932 MD Primary

Addresses

Primary practice location

2418 Sylvale Rd
Baltimore, MD 21209-1539

Mailing address

2418 Sylvale Rd
Baltimore, MD 21209-1539
Phone (410) 493-2473

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20130722000088 MD Practitioner - Clinical Social Worker 8325289168 Practice locations: Baltimore, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2418 Sylvale Rd
Baltimore, MD 21209-1539
Phone (410) 493-2473

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15932MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Inspirit Counseling Services, Inc. Clinical CurrentSince Jul 1, 2013 Accepting new patients

Locations

5407 N Charles St
Baltimore, MD 21210
Phone (410) 433-2241

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1372636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423008000000",
    "number": "1275973570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2418 SYLVALE RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212091539",
            "telephone_number": "410-493-2473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2418 SYLVALE RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212091539",
            "telephone_number": "410-493-2473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "ROBERT",
        "middle_name": "L",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-01",
        "last_updated": "2015-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "15932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.