Active NPI
Amy Jacobs
- Counselor
- Deridder, LA
National Provider Identifier
1487253100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- PLC11199
- Practice address
- 1014 N Pine St Ste a
Deridder, LA 70634-2818 - Phone
- (337) 463-4020
- Fax
- (337) 463-4033
- NPI assigned
- Oct 23, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | PLC11199 | LA | Primary |
Addresses
Primary practice location
1014 N Pine St Ste a
Deridder, LA 70634-2818
Mailing address
1000 Chinaberry Dr Ste 900
Bossier City, LA 71111-2455
Phone (337) 463-4020
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PLC11199 | LA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavioral Health Response, Inc | Counselor | Current | Accepting new patients |
Locations
5501 Delmar Blvd
Ste B300
Saint Louis, MO 63112
Phone (314) 469-4908
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Counselor
- Saint Louis, MO
- NPI 1023546967
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780272000000",
"number": "1487253100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 CHINABERRY DR STE 900",
"city": "BOSSIER CITY",
"state": "LA",
"postal_code": "711112455",
"telephone_number": "337-463-4020",
"fax_number": "337-463-4033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1014 N PINE ST STE A",
"city": "DERIDDER",
"state": "LA",
"postal_code": "706342818",
"telephone_number": "337-463-4020",
"fax_number": "337-463-4033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "AMY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-23",
"last_updated": "2026-06-01",
"certification_date": "2026-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "LA",
"license": "PLC11199",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deridder, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.