Gregg D Jacobs, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4595 Issued in MA

Practice address

85 Prescott St
Worcester, MA 01605-2610

Phone

(508) 793-4958

Fax

(508) 334-8127

NPI assigned

Oct 4, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 Psychological Center, Inc.

  • Community/Behavioral Health Agency
  • Lawrence, MA
  • NPI 1790878486
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485302400000",
    "number": "1326133604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 PRESCOTT ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052610",
            "telephone_number": "508-793-4958",
            "fax_number": "508-334-8127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "GREGG",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2017-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "4595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0520152",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110023549A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony Jacob
• Jason Varghese Jacob
• Joseph John Jacob, MD
• Marlene Denise Jacobo, MD
• Tyana Diluz Jacobs-Aloyo
• Suzanne Jacqueline Jacobs, LICSW
• Raeanne Jacobsen
• Eric William Jacobson, M.D.
• Sarah Jean Jacobson, MD
• Elie Jacques

• Clinical Psychologist in Worcester, MA
• Providers in Worcester, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.