Jacqueline A Jacobson, L.P.C.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0701002868 Issued in VA

Practice address

3700 Joseph Siewick Dr Ste 408a
Fairfax, VA 22033-1745

Phone

(703) 620-3211

Fax

(703) 620-3215

NPI assigned

Sep 9, 2005

Sex

Female

Sole proprietor

No

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

Enrolled in DC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Inova Health Care Services

  • Internal Medicine Physician
  • Falls Church, VA
  • NPI 1952320061

  DC

  Medicare reassignment Care Compare group NPD
• Inova Health Care Services

  • Medical Technologist
  • Sterling, VA
  • NPI 1699655589
  NPD
• Chase Psychological Resources, Inc.

  • Clinical Psychologist
  • Fairfax, VA
  • NPI 1063696466
  NPD (past)

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1487648085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 JOSEPH SIEWICK DR STE 408A",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331745",
            "telephone_number": "703-620-3211",
            "fax_number": "703-620-3215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 JOSEPH SIEWICK DR STE 408A",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331745",
            "telephone_number": "703-620-3211",
            "fax_number": "703-620-3215"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10721 Main St",
            "address_2": "Suite 2350",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220306914",
            "country_code": "US",
            "telephone_number": "703-591-5912 x105",
            "fax_number": "703-591-7210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "JACQUELINE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "L.P.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-09",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701002868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob T Joseph MD PC
• Allyson Jacobi
• David Alan Jacobs, LPC
• Deana Jacobs, LCPC, CCTP
• Nicole Jacobs, PT, DPT
• Susan E. Jacobson, NP
• Suzyn Jacobson, LCSW
• Sylvia Jacoub, PSYD
• Michelle Marie Jacques, RN-BC,AGPCNP-BC,CMT
• Jae Kim, MD PLC

• Mental Health Counselor in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.