Theresa Jacobsen Jacobsen, BA, CAC III

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1638 Issued in CO

Practice address

25 E 16TH Ave
Box 4
Denver, CO 80202-5195

Phone

(720) 327-2940

Fax

(303) 764-6270

NPI assigned

Apr 1, 2010

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

State licenses

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

{
    "created_epoch": "1270080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270080000000",
    "number": "1497070494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11721 HARRISON ST",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802331623",
            "telephone_number": "303-451-9377",
            "fax_number": "303-452-4978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 E 16TH AVE",
            "address_2": "BOX 4",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802025195",
            "telephone_number": "720-327-2940",
            "fax_number": "303-764-6270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "THERESA",
        "middle_name": "JACOBSEN",
        "name_prefix": "Mrs.",
        "credential": "BA, CAC III",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-01",
        "last_updated": "2010-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "1638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO ADDICTIONS COUNSELOR",
            "identifier": "1638",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shavondria Jacobs
• Bill Jacobsen, M.D.
• Nikki Jacobsen
• Rebekah Jacobsen, LPN
• Taylor Michele Jacobsen
• Dana Jacobson, OTR/L
• Daniel H Jacobson, MD
• Dinell Jacobson, P.T.
• Erika Christa Jacobson, PHARMD
• Kali Jacobson, DC

• Addiction (Substance Use Disorder) Counselor in Denver, CO
• Providers in Denver, CO by specialty
• Addiction (Substance Use Disorder) Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2010; 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.