Amanda Jean Jacobsen, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

014269 Issued in NY

Practice address

43 New Scotland Ave
Communication Disorders Department, MC-128
Albany, NY 12208-3412

Phone

(518) 262-4526

Fax

(518) 262-6896

NPI assigned

Mar 31, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456358400000",
    "number": "1780645556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 NEW SCOTLAND AVE",
            "address_2": "COMMUNICATION DISORDERS DEPARTMENT, MC-128",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083412",
            "telephone_number": "518-262-4526",
            "fax_number": "518-262-6896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 NEW SCOTLAND AVE",
            "address_2": "COMMUNICATION DISORDERS DEPARTMENT, MC-128",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083412",
            "telephone_number": "518-262-4526",
            "fax_number": "518-262-6896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "AMANDA",
        "middle_name": "JEAN",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2016-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "014269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Apryl Jacobs, PHARMD
• Edward Julius Jacobs, M.D.
• Hugh F. Jacobs, M.D.
• James Jacobs
• Siana Elizabeth Jacobs, MD
• Erik Andrew Jacobson, M.D.
• Xander Lee Jacobson
• Sukaina J Jaffer, MD
• Aasim Mahmood Jaffri, MD
• Mikram Jafri, MD

• Speech-Language Pathologist in Albany, NY
• Providers in Albany, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2016; 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.