Mary Jamia Jacobsen, LCSW, LMFT

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34002287A Issued in IN

Practice address

1515 N Post Rd Ste a
Indianapolis, IN 46219-4213

Phone

(317) 282-3088

Fax

(317) 295-2555

NPI assigned

Jul 23, 2011

Sex

Female

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1311379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1356629414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 N POST RD STE A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194213",
            "telephone_number": "317-282-3088",
            "fax_number": "317-295-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 N POST RD STE A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194213",
            "telephone_number": "317-282-3088",
            "fax_number": "317-295-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "MARY",
        "middle_name": "JAMIA",
        "credential": "LCSW, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-23",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "35000016A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34002287A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordon Jacobs, DDS
• Karalyn Jacobs, DNP, RN, FNP-C
• Katie Ann Jacobs, PHARMD
• Lauren P. Jacobs, MD
• Mary R Jacobs, M.D.
• Niels-Erik B Jacobsen, M.D.
• Lewis E Jacobson, MD
• William Jacobson, MD
• Taylor Dail Jacoby, P.A.
• Victoria Ann Jacuk, DO

• Clinical Social Worker in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.