Active NPI
Erin Jacobson, LCPC, A.T.R.
- Professional Counselor
- Oak Park, IL
National Provider Identifier
1497769038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 235 Harrison St
Oak Park, IL 60304-1533 - Phone
- (708) 712-9255
- NPI assigned
- Jul 28, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | IL | Primary |
Addresses
Primary practice location
235 Harrison St
Oak Park, IL 60304-1533
Mailing address
1944 Wesley Ave
1
Berwyn, IL 60402-1857
Phone (708) 712-9255
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01-229 | Other | IL | REGISTERED ART THERAPIST |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180-003882 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203897600000",
"number": "1497769038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1944 WESLEY AVE",
"address_2": "1",
"city": "BERWYN",
"state": "IL",
"postal_code": "604021857",
"telephone_number": "708-712-9255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "235 HARRISON ST",
"city": "OAK PARK",
"state": "IL",
"postal_code": "603041533",
"telephone_number": "708-712-9255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBSON",
"first_name": "ERIN",
"name_prefix": "Ms.",
"credential": "LCPC, A.T.R.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-28",
"last_updated": "2008-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED ART THERAPIST",
"identifier": "01-229",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oak Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.