Individual provider Active NPI

Shoshana Jacobson, MSW, ACSW, LCSW

  • Clinical Social Worker
  • Tucson, AZ
National Provider Identifier
1336493667
Registry record updated Nov 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW0694 Issued in AZ
Practice address
925 N Sonita Ave
Tucson, AZ 85711-1650
Phone
(520) 907-7667
Fax
(520) 748-7333
NPI assigned
Nov 8, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW0694 AZ Primary

Addresses

Primary practice location

925 N Sonita Ave
Tucson, AZ 85711-1650

Mailing address

925 N Sonita Ave
Tucson, AZ 85711-1650
Phone (520) 907-7667

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LCSW0694AZMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1352332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352332800000",
    "number": "1336493667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 N SONITA AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857111650",
            "telephone_number": "520-907-7667",
            "fax_number": "520-748-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 N SONITA AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857111650",
            "telephone_number": "520-907-7667",
            "fax_number": "520-748-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "SHOSHANA",
        "name_prefix": "Ms.",
        "credential": "MSW, ACSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-08",
        "last_updated": "2012-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW0694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2012; 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.