Individual provider Active NPI

Elise Jaacobi, LCSW

  • Clinical Social Worker
  • Delray Beach, FL
National Provider Identifier
1689220071
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
16158 S Military TRL
Delray Beach, FL 33484-6502
Phone
(561) 637-7522
NPI assigned
Aug 13, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

16158 S Military TRL
Delray Beach, FL 33484-6502

Mailing address

16158 S Military TRL
Delray Beach, FL 33484-6502
Phone (561) 637-7522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20191030002406 FL Practitioner - Clinical Social Worker 9032441761 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6919 SW 18 St
Boca Raton, FL 33433-7010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
South County Mental Health Center, Inc. CurrentSince Aug 14, 2019 Accepting new patients
Tools4Life Psychotherapy Clinical CurrentSince Mar 3, 2020 Accepting new patients

Locations

7100 Camino Real
Ste 302
Boca Raton, FL 33433
Phone (561) 300-4024

16158 S Military Trl
Delray Beach, FL 33484
Phone (561) 495-0522

Organizations & group practices 2

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": "1565654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1689220071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16158 S MILITARY TRL",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334846502",
            "telephone_number": "561-637-7522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16158 S MILITARY TRL",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334846502",
            "telephone_number": "561-637-7522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAACOBI",
        "first_name": "ELISE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-13",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

Verify at the official NPI Registry.