Lynn Marie Jacobs, MS LLP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301014502 Issued in MI

Practice address

618 E 11 Mile Rd
Royal Oak, MI 48067-1962

Phone

(248) 607-0793

NPI assigned

Jun 24, 2011

Last updated

Sep 21, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Lynn Jacobs Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1308873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474416000000",
    "number": "1417243767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "E. 11 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "48067",
            "telephone_number": "248-607-0793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 E 11 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480671962",
            "telephone_number": "248-607-0793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "LYNN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MS LLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-24",
        "last_updated": "2016-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6301014502",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301014502",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MI",
            "license": "6301014502",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNN",
            "last_name": "JACOBS",
            "credential": "MS LLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Russchel Jane Jackson, DNP
• Amanda Jacob, NP
• Jeffrey T Jacob, MD
• Allison Sydney-Kepes Jacobs, LLMSW
• Jodie Michelle Jacobs, LMSW
• Matthew Ryan Jacobs, DO
• Sydney Jordyn Jacobs, DO
• Daniel Steven Jacobson, P.T.
• Mark Edward Jacobson, M.D.
• Syed Jafri, MD

• Clinical Psychologist in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; 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.