Simone Jacobs, LCSW-C, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

14006 Issued in MD

Practice address

6930 Carroll Ave Ste 610
Takoma Park, MD 20912-4498

Phone

(301) 563-9156

Fax

(240) 491-5913

NPI assigned

May 27, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DC

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

Clinical Social Worker

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1417115494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6930 CARROLL AVE STE 610",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209124498",
            "telephone_number": "301-563-9156",
            "fax_number": "240-491-5913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6930 CARROLL AVE STE 610",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209124498",
            "telephone_number": "301-563-9156",
            "fax_number": "240-491-5913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "SIMONE",
        "credential": "LCSW-C, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-27",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "14006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "416691400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abdoul Issaka
• J Sadie Physical Therapy and Wellness, LLC
• Ja Community Services, LLC
• Brinton B Jackson, P.A.
• Emily Jacobs, LMT
• Juliette Melanie Jacquemet
• Jaime F. Marquez, M.D.,P.a.
• Varun Jain, DDS
• Orly Jalowski, MS
• Augustine Jam, HHA

• Clinical Social Worker in Takoma Park, MD
• Providers in Takoma Park, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; 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.