Active NPI
Joseph Y Jacobs
- Counseling Psychologist
- Passaic, NJ
National Provider Identifier
1376151670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 027640
- Practice address
- 211 Pennington Ave
Passaic, NJ 07055-4685 - Phone
- (646) 580-5481
- NPI assigned
- Jul 22, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 027640 | NY | Primary |
Addresses
Primary practice location
211 Pennington Ave
Passaic, NJ 07055-4685
Mailing address
211 Pennington Ave Apt E303
Passaic, NJ 07055-4787
Other practice location 1
13774 70th Rd
Flushing, NY 11367-1930
Phone (917) 270-6882
Other practice location 2
1268 E 14th St
Brooklyn, NY 11230-5241
Phone (718) 382-0045
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
| License | State | Type | Specialty |
|---|---|---|---|
| 027640 | NY | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772755200000",
"number": "1376151670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 PENNINGTON AVE APT E303",
"city": "PASSAIC",
"state": "NJ",
"postal_code": "070554787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 PENNINGTON AVE",
"city": "PASSAIC",
"state": "NJ",
"postal_code": "070554685",
"telephone_number": "646-580-5481"
}
],
"practiceLocations": [
{
"address_1": "13774 70th Rd",
"address_purpose": "LOCATION",
"city": "Flushing",
"state": "NY",
"postal_code": "113671930",
"country_code": "US",
"telephone_number": "917-270-6882",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1268 E 14th St",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "112305241",
"country_code": "US",
"telephone_number": "718-382-0045",
"fax_number": "718-382-0051",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACOBS",
"first_name": "JOSEPH",
"middle_name": "Y",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-07-22",
"last_updated": "2026-03-06",
"certification_date": "2026-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "NY",
"license": "027640",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Passaic, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.