Amy M.Jacobs, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

188 Issued in KS

Legal business name

AMY M.JACOBS, LLC

Practice address

7807 E Funston St
Wichita, KS 67207-3123

Phone

(316) 636-1188

NPI assigned

May 4, 2012

Last updated

May 4, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amy M. Jacobs, LCP

Title

Licensed Clinical Psychotherapist

Phone

(316) 636-1188

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1336089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336089600000",
    "number": "1770842114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7807 E FUNSTON ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672073123",
            "telephone_number": "316-636-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7807 E FUNSTON ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672073123",
            "telephone_number": "316-636-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMY M.JACOBS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-04",
        "last_updated": "2012-05-04",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "316-636-1188",
        "authorized_official_credential": "LCP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "KS",
            "license": "188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1154303659",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Wichita, KS
• Providers in Wichita, KS by specialty
• Community/Behavioral Health Agency in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2012; 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.