Carrie Jacoby, MFTI

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

IMF87708 Issued in CA

Practice address

5220 W Washington Blvd
Suite 101
Los Angeles, CA 90016

Phone

(323) 933-9186

Fax

(323) 933-7146

NPI assigned

Dec 9, 2015

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

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 and National Provider Directory roles.

• Clare Matrix

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Los Angeles, CA
  • NPI 1235349267
  NPD (past)

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

{
    "created_epoch": "1449619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1609241165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 W WASHINGTON BLVD",
            "address_2": "SUITE 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900161331",
            "telephone_number": "323-933-9186",
            "fax_number": "323-933-7146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 W WASHINGTON BLVD",
            "address_2": "SUITE 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90016",
            "telephone_number": "323-933-9186",
            "fax_number": "323-933-7146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBY",
        "first_name": "CARRIE",
        "credential": "MFTI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-09",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF87708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Jacobson, MA, CCC-SLP
• Shannon Kris Jacobson, MSW
• Sharon Diane Jacobson, MD
• Steven J. Jacobson, MD
• Bradley Alan Jacoby, D.O
• Karine Jacome Suazo
• Marina Jacome
• Natalie Elaine Jaconetty
• Fakhry Azer Jacoub, DDS
• Lisa S Jacques

• Marriage & Family Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.