Alicia Kathleen Jacobs, LICSW, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

90 Odell Hill Rd
Conway, NH 03818-4401

Phone

(603) 545-9386

NPI assigned

Aug 8, 2018

Last updated

Jun 29, 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

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.

• Life Examined LLC

  • Clinical Social Worker
  • Conway, NH
  • NPI 1902521628
  NPD Authorized official
• Northern Human Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Center Conway, NH
  • NPI 1700955028
  NPD (past)

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1598244824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 521",
            "city": "MADISON",
            "state": "NH",
            "postal_code": "038490521",
            "telephone_number": "603-545-9386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 ODELL HILL RD",
            "city": "CONWAY",
            "state": "NH",
            "postal_code": "038184401",
            "telephone_number": "603-545-9386"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 W Main St",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "NH",
            "postal_code": "038186142",
            "country_code": "US",
            "telephone_number": "603-447-2111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "ALICIA",
        "middle_name": "KATHLEEN",
        "credential": "LICSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-08",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC20858",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Hoyt, WAIVER
• Franklin Rutledge Hubbell, DO
• Tobias Hunt
• William Hyde
• Amber Teren Ives, FNP
• James W. Iovino, Lcmhc, Inc.
• Bryn Jay
• Leonard Jewell, WAIVER
• Gale A Johnsen, FNP
• Diane Wilson Johnson, LCMHC

• Social Worker in Conway, NH
• Providers in Conway, NH by specialty
• Social Worker in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.