Lillie Marie Jacobs, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C002751 Issued in NC

Practice address

3125 Eastway Drive
Suite 109
Charlotte, NC 28205

Phone

(704) 566-9437

Fax

(704) 566-9437

NPI assigned

May 15, 2006

Last updated

Nov 10, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in NC, SC2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

BMSC NC LLCGroup PAC ID 9739445552, 11 clinicians

BMSC Az LLCGroup PAC ID 4385929173, 130 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• BMSC Az LLC

  • Clinical Social Worker
  • Plainfield, IL
  • NPI 1497201875

  SC

  Medicare reassignment Care Compare group NPD
• BMSC NC LLC

  • Clinical Social Worker
  • Plainfield, IL
  • NPI 1831611649

  NC

  Medicare reassignment Care Compare group NPD
• Oasis Counseling Service

  • Mental Health Counselor
  • Charlotte, NC
  • NPI 1053837500
  NPD Authorized official

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1750332540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 EASTWAY DRIVE",
            "address_2": "SUITE 109",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28205",
            "telephone_number": "704-566-9437",
            "fax_number": "704-566-9437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 EASTWAY DRIVE",
            "address_2": "SUITE 109",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28205",
            "telephone_number": "704-566-9437",
            "fax_number": "704-566-9437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "LILLIE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "C002751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VMC BEHAVIORAL",
            "identifier": "026940",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "3077B1531",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMP PSYCH",
            "identifier": "262210",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "555280",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MENTAL HEALTH NETWORK",
            "identifier": "QMXTR0029414",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "13318",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6002517",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dennis Michael Jacobs, D.O.
• Elise Rodriguez Jacobs
• Felicia Jacobs, RPH
• Gordon W Jacobs, M.D.
• Lane K. Jacobs, MD
• Lorraine Maria Jacobs, RN
• Nancy H. Jacobs, CRNA
• Navaeh Jacobs
• Ryan Wayne Jacobs, MD
• Shadale Nicole Jacobs, MS, LCMHCA

• Mental Health Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.