Chad Christopher Jacobs, MED, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

C2925 Issued in OR

Practice address

9755 SW Barnes Rd Ste 650
Portland, OR 97225-6657

Phone

(503) 444-4862

Fax

(503) 648-0755

NPI assigned

Jul 30, 2013

Sex

Male

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

Enrolled in OR

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

Specialty

Mental Health Counselor

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Western Psychological and Counseling Services LLCGroup PAC ID 7719975085, 331 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.chadjacobs@148835.advancedmd-direct.com

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.

• Western Psychological and Counseling Services LLC

  dba LifeStance Health

  • Clinical Psychologist
  • Tacoma, WA
  • NPI 1912008178

  Counselor, OR

  Medicare reassignment Care Compare group NPD
• Western Psychological and Counseling Services LLC

  dba LifeStance Health

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1629345731

  Counselor

  NPD

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

{
    "created_epoch": "1375142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1689006850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 NW AUTUMNCREEK WAY",
            "address_2": "#L305",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970069008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9755 SW BARNES RD STE 650",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256657",
            "telephone_number": "503-444-4862",
            "fax_number": "503-648-0755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "CHAD",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Mr.",
        "credential": "MED, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-30",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "LA",
            "license": "3741",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": "C2925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tirzah D Jacob, LPC
• Christy Jacobo, RN
• Kimberly Jacobowitz, LCSW
• Betony M Jacobs
• Caroline N Jacobs, PHD, APRN
• Christopher John Jacobs, B.S
• Emily Jacobs
• Gabrielle Jacobs
• Heather Jacobs, MPA, NBC-HWC
• Heather Anne Jacobs, CNM, WHNP

• Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.