Stefanie Jacobson

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

09889 Issued in MD

Practice address

499 Alt Keene Rd
Largo, FL 33771-1652

Phone

(727) 586-4211

NPI assigned

Aug 9, 2021

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

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": "1628467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1447925888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25117 SW PARKWAY AVE STE D",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 ALT KEENE RD",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337711652",
            "telephone_number": "727-586-4211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "STEFANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-09",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "09889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Donald Jackson, DDS
• Robin Jackson
• Joshlyn Jacob, AUD
• Frank Mac Jacobs, LMFT, LMHC, CAP
• Nathan David Jacobsen, DO
• Jaime Medical, Inc.
• Christopher Jainandan, LMHC, NCC
• Betty Jakubik-Randolph, PTA
• Jesse Jakubowski, DMD
• Jam Medical, Inc.

• Speech-Language Pathologist in Largo, FL
• Providers in Largo, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.