Craig Brian Jacobson, AAC, CDPT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CP60418176 Issued in WA

Practice address

6100 Southcenter Blvd
Sound Mental Health, Suite 200
Tukwila, WA 98188-2441

Phone

(206) 444-7946

Fax

(206) 444-7810

NPI assigned

Mar 13, 2009

Last updated

Jan 23, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1236902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1316188717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 E OLIVE ST",
            "address_2": "SOUND MENTAL HEALTH",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981222735",
            "telephone_number": "206-302-2200",
            "fax_number": "206-302-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 SOUTHCENTER BLVD",
            "address_2": "SOUND MENTAL HEALTH, SUITE 200",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981882441",
            "telephone_number": "206-444-7946",
            "fax_number": "206-444-7810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "CRAIG",
        "middle_name": "BRIAN",
        "name_prefix": "Mr.",
        "credential": "AAC, CDPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-13",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60418176",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CG60111492",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Intanam
• Angela Irvine, LMP
• Courtney Ann Isenbarger, SUDP
• Katherine Ellenor Ishizuka, BA, CDPT
• Jerrold Jackson
• Jadivan Jacobson, LAAC
• Ada Jonee Jacquemart
• Cassidy Renee Jacquez
• Fredda Jaffe, M.S., LMFT
• Lindsay Jahng

• Addiction (Substance Use Disorder) Counselor in Tukwila, WA
• Providers in Tukwila, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; 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.