Individual provider Active NPI

Rebecca Jacobs, LCSW - C

  • Clinical Social Worker
  • Gaithersburg, MD
National Provider Identifier
1497467179
Registry record updated Dec 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
23247 Issued in MD
Practice address
610 E Diamond Ave Ste 100
Gaithersburg, MD 20877-5321
Phone
(301) 466-5492
NPI assigned
Dec 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 23247 MD Primary

Addresses

Primary practice location

610 E Diamond Ave Ste 100
Gaithersburg, MD 20877-5321

Mailing address

610 E Diamond Ave Ste 100
Gaithersburg, MD 20877-5321
Phone (301) 840-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240719000167 MD Practitioner - Clinical Social Worker 9830635457 Reassigns benefits to 1 organization
I20240802002382 DC Practitioner - Clinical Social Worker 9830635457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senior Care Therapy LCSW of Maryland LLCGroup PAC ID 5597174797, 13 clinicians

Practice addresses (Care Compare)

2700 Barker St
Silver Spring, MD 20910-1001
Phone (973) 264-0023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13582MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Care Therapy LCSW of Maryland LLC Clinical CurrentSince Jun 1, 2024 Accepting new patients

Locations

2719 Hollywood Blvd
Hollywood, FL 33020
Phone (954) 354-2555

822 Guilford Ave
#1526
Baltimore, MD 21202
Phone (973) 295-6335

2700 Barker St
Silver Spring, MD 20910
Phone (301) 565-0300

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.

NPI Registry JSON

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

{
    "created_epoch": "1670976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1497467179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 E DIAMOND AVE STE 100",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208775321",
            "telephone_number": "301-840-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 E DIAMOND AVE STE 100",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208775321",
            "telephone_number": "301-466-5492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "REBECCA",
        "credential": "LCSW - C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-14",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "23247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

Verify at the official NPI Registry.