Active NPI
Elyse Merrick Jacobson, LPC, LAC
- Professional Counselor
- Englewood, CO
National Provider Identifier
1760855381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4231
- Practice address
- 155 Inverness Dr W
Englewood, CO 80112-5095 - Phone
- (303) 768-7548
- NPI assigned
- Nov 4, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 137 | CO | |
| Professional Counselor | 101YP2500X | 4231 | CO | Primary |
Addresses
Primary practice location
155 Inverness Dr W
Englewood, CO 80112-5095
Mailing address
155 Inverness Dr W
Englewood, CO 80112-5095
Phone (303) 768-7548
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4231 | CO | MD | Professional Counselor |
| 137 | CO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446595200000",
"number": "1760855381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 INVERNESS DR W",
"city": "ENGLEWOOD",
"state": "CO",
"postal_code": "801125095",
"telephone_number": "303-768-7548"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 INVERNESS DR W",
"city": "ENGLEWOOD",
"state": "CO",
"postal_code": "801125095",
"telephone_number": "303-768-7548"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBSON",
"first_name": "ELYSE",
"middle_name": "MERRICK",
"credential": "LPC, LAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-04",
"last_updated": "2015-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CO",
"license": "137",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "4231",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Englewood, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.