Amy Lee Jacobs, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

078271 Issued in NY

Practice address

127 West State St
Ithaca, NY 14850-5474

Phone

(607) 273-7494

NPI assigned

Jan 8, 2007

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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.

• Family and Children Services of Ithaca

  • Social Worker
  • Ithaca, NY
  • NPI 1306077425
  NPD (past)

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324512000000",
    "number": "1316095714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 W STATE ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505474",
            "telephone_number": "607-273-7497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 WEST STATE ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505474",
            "telephone_number": "607-273-7494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "AMY",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2011-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "078271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alisson Daniela Iturburu Altamirano, M.D.
• William Roy Ives
• Yudelka Garcia Ivory, N.P.
• Mark Franklin Jackson, P.T., DPT, MPS, OCS
• Jaclyn Borza Maher, D.C., PLLC
• Paula L. Jacobs, LCSW
• Patti L Jacobson, DC
• Kimberly Brett Jakobson
• Maureen Bernier Jakubson, OTR
• Lucia Jander, MD

• Clinical Social Worker in Ithaca, NY
• Providers in Ithaca, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.