Logan Michele Jacobson

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

67-29 Myrtle Ave
Glendale Mental Health Clinic
Glendale, NY 11385

Phone

(631) 404-8277

NPI assigned

Sep 28, 2009

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1254096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1497089247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67-29 MYRTLE AVE",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "11385",
            "telephone_number": "631-404-8277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67-29 MYRTLE AVE",
            "address_2": "GLENDALE MENTAL HEALTH CLINIC",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "11385",
            "telephone_number": "631-404-8277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "LOGAN",
        "middle_name": "MICHELE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Inessa Inoyatova
• Internal Medicine Wellbeing PLLC
• Thelma Centinella Isaac
• Ella Ismailova
• Petr Itzhak, D.O.
• Elsie V Jacques, MSW
• David Jakubowitz, DDS
• Alice Mary Jannazzo, RPH
• Miriam Filali Jaouhari
• Jasjit K. Pawha, Physician, P.C.

• Social Worker in Glendale, NY
• Providers in Glendale, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.