Individual provider Active NPI

Jacob E Korbakes, LMSW

  • Clinical Social Worker
  • Coralville, IA
National Provider Identifier
1710875638
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
131235 Issued in IA
Practice address
2771 Oakdale Blvd Ste 6
Coralville, IA 52241-9747
Phone
(319) 595-2699
NPI assigned
Jun 27, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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 131235 IA Primary

Addresses

Primary practice location

2771 Oakdale Blvd Ste 6
Coralville, IA 52241-9747

Mailing address

2233 Willenbrock Cir
Iowa City, IA 52245-1512
Phone (831) 233-0912

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
131235IAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1750982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1710875638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 WILLENBROCK CIR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522451512",
            "telephone_number": "831-233-0912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2771 OAKDALE BLVD STE 6",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522419747",
            "telephone_number": "319-595-2699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORBAKES",
        "first_name": "JACOB",
        "middle_name": "E",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-27",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "131235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coralville, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; 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.