Active NPI
Kristen Jacobsen, LCPC
- Professional Counselor
- Northbrook, IL
National Provider Identifier
1386989929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180008355
- Practice address
- 601 Skokie Blvd
Suite 207
Northbrook, IL 60062 - Phone
- (773) 633-9075
- NPI assigned
- Dec 9, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180008355 | IL | Primary |
Addresses
Primary practice location
601 Skokie Blvd
Suite 207
Northbrook, IL 60062
Mailing address
7915 Foster St
Morton Grove, IL 60053
Phone (773) 633-9075
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 31, 2026 through Mar 31, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180008355 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644192000000",
"number": "1386989929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7915 FOSTER ST",
"city": "MORTON GROVE",
"state": "IL",
"postal_code": "60053",
"telephone_number": "773-633-9075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 SKOKIE BLVD",
"address_2": "SUITE 207",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "60062",
"telephone_number": "773-633-9075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBSEN",
"first_name": "KRISTEN",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-12-09",
"last_updated": "2022-02-07",
"certification_date": "2022-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180008355",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northbrook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.