Carolyn M Jacoby, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60614321 Issued in WA

Practice address

4850 S Thompson Ave
Tacoma, WA 98408

Phone

(941) 600-6656

NPI assigned

Jun 30, 2015

Last updated

Jul 26, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1568845188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 S THOMPSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984085733",
            "telephone_number": "941-600-6656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 S THOMPSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98408",
            "telephone_number": "941-600-6656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1660 S Columbian Way",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981081532",
            "country_code": "US",
            "telephone_number": "206-762-1010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBY",
        "first_name": "CAROLYN",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-30",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11574",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60614321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICSW",
            "identifier": "LW60614321",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "SW11574",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maisy Jacobsen, PA STUDENT
• Rebecca Jacobsen, LICSW
• Joshua M Jacobson, DO
• Peter Jacobson
• Seth Joseph Jacobson, RN
• Miguel Jacome Jr., EFDA ASSISTANT
• Nicolae Ion Jacot, AA
• Pete A. Jacques, PA-C
• Dorothy M Jaeger
• Zubeir Noordin Jaffer, MD

• Clinical Social Worker in Tacoma, WA
• Providers in Tacoma, 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 Jul 26, 2018; 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.