Justin Jacobson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12212856-3501 Issued in UT

Practice address

1255 N 1200 W
Orem, UT 84057-2445

Phone

(801) 229-1181

NPI assigned

Oct 20, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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": "1603152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1457950529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 N 1200 W",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840572445",
            "telephone_number": "801-229-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 N 1200 W",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840572445",
            "telephone_number": "801-229-1181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 N Freedom Blvd",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846011677",
            "country_code": "US",
            "telephone_number": "801-373-4760",
            "fax_number": "801-373-0639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "JUSTIN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-20",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "12212856-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Todd Jackson
• Hallie Karma Jacobia
• Tad Wesley Jacobs
• Tammy Ting-Yu Shen Jacobs, M.D.
• Erin McKayla Jacobsen
• Stacie Jacobson
• James I Hoyal DPM PC
• Jamie at Aspen LLC
• Jessica Danielle Jarvis
• Julie Jarvis

• Clinical Social Worker in Orem, UT
• Providers in Orem, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.