Individual provider Active NPI

Jami Lynn Jacobson, LMHC

  • Mental Health Counselor
  • Brooklyn, NY
National Provider Identifier
1326788753
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
012191-01 Issued in NY
Practice address
1517 Dekalb Ave Apt 3R
Brooklyn, NY 11237-3637
Phone
(406) 212-0767
NPI assigned
Apr 1, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 012191-01 NY Primary

Addresses

Primary practice location

1517 Dekalb Ave Apt 3R
Brooklyn, NY 11237-3637

Mailing address

1517 Dekalb Ave Apt 3R
Brooklyn, NY 11237-3637
Phone (406) 212-0767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240212000763 FL Practitioner - Mental Health Counselor 7113360710 Reassigns benefits to 1 organization
I20240217000381 NY Practitioner - Mental Health Counselor 7113360710 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
012191-01NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
MCCD Psychiatry Services PLLC CurrentSince Jan 1, 2024 Accepting new patients
MCCD FL Psychiatry Services PA CurrentSince Jan 7, 2024 Accepting new patients

Locations

1301 Riverplace Blvd
Jacksonville, FL 32207

1301 Riverplace Blvd
Ste 800
Jacksonville, FL 32207
Phone (904) 567-6040

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1648771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1326788753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1517 DEKALB AVE APT 3R",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112373637",
            "telephone_number": "406-212-0767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1517 DEKALB AVE APT 3R",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112373637",
            "telephone_number": "406-212-0767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "JAMI",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-01",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "012191-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.