Jacoba De Boer, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1318-8-15-23 Issued in ND

Practice address

3535 S 31St St Ste 201
Grand Forks, ND 58201-3593

Phone

(701) 780-6821

Fax

(701) 780-1973

NPI assigned

Aug 20, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

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 1

Specialty

Mental Health Counselor

Education

University of North Dakota School of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Assessment and Therapy Associates of Grand Forks PLLCGroup PAC ID 9436152626, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Assessment and Therapy Associates of Grand Forks, PLLC

  • Clinical Psychologist
  • Grand Forks, ND
  • NPI 1437181591
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1755648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1376420414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 S 31ST ST STE 201",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582013593",
            "telephone_number": "701-780-6821",
            "fax_number": "701-780-1973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 S 31ST ST STE 201",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582013593",
            "telephone_number": "701-780-6821",
            "fax_number": "701-780-1973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE BOER",
        "first_name": "JACOBA",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-20",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ND",
            "license": "1318-8-15-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Ranae Davis
• Ella Davis, LMSW
• Miranda Eden Davis, PMHNP
• Rachel Anne Davis, MA OTR/L
• Taneka Davis
• Magnolia De Guzman, MD
• Abigail De Witt
• Kyle Patrick De Young, PH.D.
• Taylor Dean, LBSW
• Donald John Debeltz, MD

• Professional Counselor in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Professional Counselor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.