Jaclyn E. Jacobs LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

JACLYN E. JACOBS LLC

Practice address

401 S 2ND St Ste 401
Philadelphia, PA 19147-1612

Phone

(267) 388-0465

NPI assigned

Jan 19, 2020

Organization subpart

No

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

Authorized official

Name

Jaclyn E Jacobs, MS, CRCNPI 1376173377

Title

Owner

Phone

(304) 549-4215

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jaclyn Jacobs, LPCC

  • Mental Health Counselor
  • San Diego, CA
  • NPI 1376173377
  NPD Authorized official

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

{
    "created_epoch": "1579392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579392000000",
    "number": "1730719733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 LOCUST ST APT 1515",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191024315",
            "telephone_number": "304-549-4215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S 2ND ST STE 401",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191471612",
            "telephone_number": "267-388-0465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACLYN E. JACOBS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-19",
        "last_updated": "2020-01-19",
        "certification_date": "2020-01-19",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "JACLYN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-549-4215",
        "authorized_official_credential": "MS, CRC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tahira Naomi Jackson, LCSW
• Tajah Jackson
• Tiffany Renee Jackson, M.S.ED.
• Tracey Jackson
• Troy Jackson, LSW
• Anju Jacob
• Anshu Jacob, PA-C
• Anumol Jacob, CRNP
• Anupama Kuriakose Jacob, PHARM D
• Arica Jacob

• Mental Health Clinic/Center (Including Community Mental Health Center) in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2020; 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.