Parker Jadin Cameron Jacobs, MS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMH26019 Issued in FL

Practice address

8081 38TH Ave N
St Petersburg, FL 33710-1029

Phone

(727) 345-2667

Fax

(727) 209-2667

NPI assigned

Jun 19, 2024

Sex

Male

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)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Costello Center

  • Mental Health Counselor
  • Saint Petersburg, FL
  • NPI 1386889145
  NPD (past)

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1295579993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8081 38TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337101029",
            "telephone_number": "727-345-2667",
            "fax_number": "727-209-2667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8081 38TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337101029",
            "telephone_number": "727-345-2667",
            "fax_number": "727-209-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "PARKER",
        "middle_name": "JADIN CAMERON",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-19",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH26019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vernita M. Jackson, CM
• Virginia Anne Jackson
• Jasmine Rose Jacob, MD
• Salil G Jacob, MD
• Jeffrey P Jacobs, M.D.
• Ashley Nicole Jacobson
• Edward Charles Jacobson I, D.O.
• Jacquelyn Murolo Inc
• Jade Tree Wellness Center, Inc.
• Elizabeth Ann Jaegle-Tolli, LMHC

• Mental Health Counselor in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.