John Douglas Jaco, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61523528 Issued in WA

Practice address

19895 4TH Ave NE
Unit a
Poulsbo, WA 98370-7481

Phone

(425) 658-0727

NPI assigned

Aug 1, 2024

Sex

Male

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

Enrolled in WA

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 Social Worker

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Teletherapeutics Health IncGroup PAC ID 7719375385, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Teletherapeutics Health Inc

  • Clinical Psychologist
  • Spokane, WA
  • NPI 1508436528
  Medicare reassignment Care Compare group NPD
• Snohomish Psychology Associates, PLLC

  • Clinical Psychologist
  • Everett, WA
  • NPI 1497178206
  NPD (past)

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

{
    "created_epoch": "1722470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1518796945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 WEST RIVERSIDE AVE",
            "address_2": "SUITE 4309",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010580",
            "telephone_number": "888-420-0589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19895 4TH AVE NE",
            "address_2": "UNIT A",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707481",
            "telephone_number": "425-658-0727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACO",
        "first_name": "JOHN",
        "middle_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-01",
        "last_updated": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61523528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Im Professional Services LLC (Kitsap Sleep & TMJ Center)
• Im Professional Services PLLC
• Simone A Ince, MD
• Inhealth Imaging, LLC
• Jackie Snapp, DDS, PLLC
• Lea Renae Jacobson, MPT
• Yamile Jana, CLINICAL PSYCH
• Lorenzo Matthew Jarin, BCBA
• Teresa Jarin
• Jessica Elizabeth Jarrett, DPT

• Clinical Social Worker in Poulsbo, WA
• Providers in Poulsbo, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; 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.