Mark Allen Jacocks

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4879 Issued in TN

Practice address

7209 Hamilton Acres Cir
Chattanooga, TN 37421-8623

Phone

(423) 499-9335

Fax

(423) 499-9334

NPI assigned

May 6, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• The Transformation Center

  • Professional Counselor
  • Chattanooga, TN
  • NPI 1518117597
  Medicare reassignment

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

{
    "created_epoch": "1620259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1730763780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7209 HAMILTON ACRES CIR",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374218623",
            "telephone_number": "423-499-9335",
            "fax_number": "423-499-9334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7209 HAMILTON ACRES CIR",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374218623",
            "telephone_number": "423-499-9335",
            "fax_number": "423-499-9334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOCKS",
        "first_name": "MARK",
        "middle_name": "ALLEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-06",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TN",
            "license": "4879",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "4879",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "4879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Cheree Jacobs, PHARMD
• Kathleen Elizabeth Jacobs, CNM
• Michael Evans Jacobs, DO
• Edward L Jacobson, MD
• Samuel S Jacobson, MD
• Alice Jada
• Jaffe Shoe Stores, Inc. (sonny sanders, c.ped)
• Salik Jahania, MD
• Hayden Erich Jahn, M.D.
• Marcus Steven Jakubiszak

• Mental Health Counselor in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Mental Health Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; 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.