Individual provider Active NPI

Lara J. Jakobsons, PH.D.

  • Clinical Psychologist
  • Evanston, IL
National Provider Identifier
1346664265
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071008778 Issued in IL
Practice address
636 Church St Ste 405
Evanston, IL 60201-4580
Phone
(847) 250-9959
Fax
(847) 306-8113
NPI assigned
Feb 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071008778 IL Primary

Addresses

Primary practice location

636 Church St Ste 405
Evanston, IL 60201-4580

Mailing address

636 Church St Ste 405
Evanston, IL 60201-4580
Phone (847) 250-9959

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071008778ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Mind Health Inc Clinical Current Accepting new patients
Endeavor Health Clinical Operations Past Accepting new patients

Locations

636 Church St
Ste 405
Evanston, IL 60201
Phone (224) 259-2271

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": "1392163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1346664265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 CHURCH ST STE 405",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014580",
            "telephone_number": "847-250-9959",
            "fax_number": "847-306-8118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 CHURCH ST STE 405",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014580",
            "telephone_number": "847-250-9959",
            "fax_number": "847-306-8113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAKOBSONS",
        "first_name": "LARA",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-12",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; 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.