Individual provider Active NPI

Cynthia Deck Jacobson, MED., LPC

  • Professional Counselor
  • Denton, TX
National Provider Identifier
1679653216
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
12769 Issued in TX
Practice address
1300 Fulton St Ste 402
Denton, TX 76201-2661
Phone
(940) 314-3334
Fax
(940) 898-8527
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 12769 TX Primary

Addresses

Primary practice location

1300 Fulton St Ste 402
Denton, TX 76201-2661

Mailing address

1300 Fulton St Ste 402
Denton, TX 76201-2661
Phone (940) 314-3334

Other identifiers 3

IdentifierTypeStateIssuer
80511LOtherTXBCBS PROVIDER NUMBER
10029880OtherTXAMERIGROUP PROVIDER NUMBE
095433101MedicaidTX

Other names 1

  • Cindy Deck Jacobson Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20260318000300 TX Practitioner - Mental Health Counselor 8628019726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1986
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1300 Fulton St
Suite 402
Denton, TX 76201-2604

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
12769TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
CCD Counseling PA CurrentSince Jun 5, 2012 Accepting new patients

Locations

1512 Scripture St
Denton, TX 76201
Phone (800) 897-7068

2800 Shoreline Dr
Ste 260
Denton, TX 76210
Phone (940) 314-3334

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1679653216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 FULTON ST STE 402",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762012661",
            "telephone_number": "940-314-3334",
            "fax_number": "940-898-8527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 FULTON ST STE 402",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762012661",
            "telephone_number": "940-314-3334",
            "fax_number": "940-898-8527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "CYNTHIA",
        "middle_name": "DECK",
        "name_prefix": "Mrs.",
        "credential": "MED., LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "12769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "80511L",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP PROVIDER NUMBE",
            "identifier": "10029880",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "095433101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CINDY",
            "last_name": "JACOBSON",
            "middle_name": "DECK",
            "credential": "MED., LPC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Denton, TX

Sources for this page

Verify at the official NPI Registry.