Emilie Ann Irene Jacobsen, ADCA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

AD8843 Issued in ME

Practice address

689 Odlin Rd
Bangor, ME 04401-6709

Phone

(207) 947-6800

Fax

(207) 947-6872

NPI assigned

Jul 29, 2024

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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 and National Provider Directory roles.

• Discovery House BR, Inc.

  • Methadone Clinic
  • Bangor, ME
  • NPI 1285827527
  NPD

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

{
    "created_epoch": "1722211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1407685563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "689 ODLIN RD",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016709",
            "telephone_number": "207-947-6800",
            "fax_number": "207-947-6872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "689 ODLIN RD",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016709",
            "telephone_number": "207-947-6800",
            "fax_number": "207-947-6872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "EMILIE",
        "middle_name": "ANN IRENE",
        "credential": "ADCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-29",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "AD8843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori S Isenhower, DO
• Sally W Ives, LPE
• Abimbola Mary Iwegbulam, NP
• Lauri Jacobs, RD,CDE
• Lisa Jacobs, PMHNP
• Meghan L Jacques, PAC
• Rosanne Sarita Jagger, MD
• John R. Jaksa, LCSW
• Maynard L Jalbert, LCPC
• James R. Curtis MD PA

• Addiction (Substance Use Disorder) Counselor in Bangor, ME
• Providers in Bangor, ME by specialty
• Addiction (Substance Use Disorder) Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.