Madeleine Kay Jacobson, LICSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

1030563 Issued in MA

Practice address

30 Lincoln St
Newton Highlands, MA 02461-1527

Phone

(617) 332-8831

NPI assigned

Oct 17, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mrs. Madeleine Kay Jacobson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192579200000",
    "number": "1649469412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 LINCOLN ST",
            "city": "NEWTON HIGHLANDS",
            "state": "MA",
            "postal_code": "024611527",
            "telephone_number": "617-332-8831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 LINCOLN ST",
            "city": "NEWTON HIGHLANDS",
            "state": "MA",
            "postal_code": "024611527",
            "telephone_number": "617-332-8831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "MADELEINE",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-17",
        "last_updated": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "1030563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BS INDEMNITY",
            "identifier": "JAPO2473",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADELEINE",
            "last_name": "JACOBSON",
            "middle_name": "KAY",
            "prefix": "MRS.",
            "credential": "LICSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Mental Health Counselor in Newton Highlands, MA
• Providers in Newton Highlands, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; 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.