Jessica A Jacob

Primary specialty

Social WorkerTaxonomy code 104100000X

License

SW-GTL-20-01766 Issued in NJ

Practice address

2 Paragon Way Ste 800
Freehold, NJ 07728-9573

Phone

(732) 393-8391

Fax

(732) 308-4500

NPI assigned

Oct 13, 2022

Last updated

Nov 17, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tree of Life Counseling Center, LLC

  • Mental Health Counselor
  • Freehold, NJ
  • NPI 1841711306

  Clinical

  NPD

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

{
    "created_epoch": "1665619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1497471288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "396 MADISON GDNS",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PARAGON WAY STE 800",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077289573",
            "telephone_number": "732-393-8391",
            "fax_number": "732-308-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "JESSICA",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-13",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "SW-GTL-20-01766",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "SW-GTL-20-01766",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J C Digiacomo, MD., LLC
• J Calvin Chatlos MD LLC (John C Chatlos MD)
• Jackson Family Practice LLC
• Alina Jackson, DPT
• Jennell A Jackson, LCSW
• Syed Ali Jaffari, HIS
• Avish Kumar Jain, DO
• Vini Jain
• Allita I Jaiyeola, BCBA
• James S McCaughan MD PA

• Social Worker in Freehold, NJ
• Providers in Freehold, NJ by specialty
• Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.