Active NPI
Scott C. Jacobs, LPC
- Mental Health Counselor
- Lubbock, TX
National Provider Identifier
1477559177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 14382
- Practice address
- 3601 4TH St
Lubbock, TX 79430-0002 - Phone
- (806) 743-2981
- Fax
- (806) 743-2984
- NPI assigned
- Jun 27, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 14382 | TX | Primary |
Addresses
Primary practice location
3601 4TH St
Lubbock, TX 79430-0002
Mailing address
PO Box 5865
Lubbock, TX 79408-5865
Phone (806) 743-2898
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 80534 | Medicaid | NM | |
| 84333Z | Other | TX | HMO BLUE |
| 80534 | Other | NM | PRESBYTERIAN COMMERCIAL |
| 82938L | Other | TX | BC/BS |
| A463 | Other | TRIWEST |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 7, 2024 through Jun 7, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14382 | TX | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1477559177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5865",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794085865",
"telephone_number": "806-743-2898",
"fax_number": "806-743-2787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3601 4TH ST",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794300002",
"telephone_number": "806-743-2981",
"fax_number": "806-743-2984"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "SCOTT",
"middle_name": "C.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-27",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "14382",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "80534",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMO BLUE",
"identifier": "84333Z",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRESBYTERIAN COMMERCIAL",
"identifier": "80534",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "82938L",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRIWEST",
"identifier": "A463",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.