Brian Jacobson, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

016535 Issued in NY

Practice address

26 W 9TH St
Suite 5C
New York, NY 10011-8971

Phone

(212) 254-1618

Fax

(212) 254-2427

NPI assigned

Apr 17, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Jacobson Psychological Services P.C.

  • Clinical Psychologist
  • New York, NY
  • NPI 1194135194
  NPD (past) Authorized official

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301875200000",
    "number": "1730305202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 W 9TH ST",
            "address_2": "SUITE 5C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118971",
            "telephone_number": "212-254-1618",
            "fax_number": "212-254-2427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 W 9TH ST",
            "address_2": "SUITE 5C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118971",
            "telephone_number": "212-254-1618",
            "fax_number": "212-254-2427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2011-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "016535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacobson and Chubak Endodontics PLLC
• Jacobson Psychological Services P.C.
• Adam Jacobson, LCSW, MSOD
• Adam Saul Jacobson, M.D.
• Blaise Yael Jacobson, LMSW
• Carly Morgan Jacobson, OTR/L
• Claudia Toby Jacobson, MSW
• David Brian Jacobson, DMD
• Eliana Jacobson, MD
• Elizabeth Leef Jacobson, MD

• Clinical Psychologist in New York, NY
• Providers in New York, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2011; 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.