Deana Jacobs, LCPC, CCTP

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LC12105 Issued in MD

Practice address

10203 Glen Chase CT
Fairfax, VA 22032-3271

Phone

(443) 421-6720

NPI assigned

Dec 23, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1640217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1437819927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10203 GLEN CHASE CT",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220323271",
            "telephone_number": "443-421-6720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10203 GLEN CHASE CT",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220323271",
            "telephone_number": "443-421-6720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "DEANA",
        "credential": "LCPC, CCTP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-23",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC12105",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MD",
            "license": "LC12105",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC12105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "djacobs@insighttreatmentcenters.net",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "10203 Glen Chase Ct",
            "city": "Fairfax",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220323271",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Megan Nicole Jackson
• Simajah Dominique Jackson, LCSW
• Jacob T Joseph MD PC
• Allyson Jacobi
• David Alan Jacobs, LPC
• Nicole Jacobs, PT, DPT
• Jacqueline A Jacobson, L.P.C.
• Susan E. Jacobson, NP
• Suzyn Jacobson, LCSW
• Sylvia Jacoub, PSYD

• Professional Counselor in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; 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.