Karen A. Jacobi, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

R0461 Issued in MO

Practice address

970 Executive Parkway Dr
St. John's Family Therapy
Saint Louis, MO 63141-6302

Phone

(314) 628-6550

Fax

(314) 514-9910

NPI assigned

Dec 13, 2006

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

Medicare fee-for-service enrollment

Enrolled in MO

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 1

Specialty

Clinical Psychologist

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinic Child and Adolescent Psychiatry LLCGroup PAC ID 7113981721, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

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 and National Provider Directory roles.

• Mercy Clinic Child and Adolescent Psychiatry, LLC

  • Child & Adolescent Psychiatry Physician
  • Saint Louis, MO
  • NPI 1265562300
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195430400000",
    "number": "1497816284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 EXECUTIVE PARKWAY DR",
            "address_2": "ST. JOHN'S FAMILY THERAPY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416302",
            "telephone_number": "314-628-6550",
            "fax_number": "314-514-9910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 EXECUTIVE PARKWAY DR",
            "address_2": "ST. JOHN'S FAMILY THERAPY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416302",
            "telephone_number": "314-628-6550",
            "fax_number": "314-514-9910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBI",
        "first_name": "KAREN",
        "middle_name": "A.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MO",
            "license": "R0461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maureen Jacob
• Saji Jacob, MD
• Sindhu Saji Jacob, MD
• Celina Rose Jacobi, MD
• Jennifer Marie Jacobi, PNP
• Jacqueline Lisa Jacobs-Gourtzelis, M.D.
• Allen M Jacobs, DPM
• Christine K Jacobs, MD
• Helen Jacobs, DMD
• Jamell J Jacobs, M.ED., NCC, PLPC

• Clinical Child & Adolescent Psychologist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Child & Adolescent Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.