Active NPI
Laura Lee Jacobson, LCSW
- Clinical Social Worker
- New York, NY
National Provider Identifier
1295929123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- PO62768-1
- Practice address
- 242 E 72ND St
Suite 1a
New York, NY 10021-4574 - Phone
- (212) 452-4214
- NPI assigned
- Sep 4, 2007
- Last updated
- May 20, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | PO62768-1 | NY | Primary |
Addresses
Primary practice location
242 E 72ND St
Suite 1a
New York, NY 10021-4574
Mailing address
242 E 72ND St
Suite 1a
New York, NY 10021-4574
Phone (212) 452-4214
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jul 1, 2017 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PO62768-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463702400000",
"number": "1295929123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "242 E 72ND ST",
"address_2": "SUITE 1A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100214574",
"telephone_number": "212-452-4214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "242 E 72ND ST",
"address_2": "SUITE 1A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100214574",
"telephone_number": "212-452-4214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBSON",
"first_name": "LAURA",
"middle_name": "LEE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-09-04",
"last_updated": "2016-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "PO62768-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.