Active NPI
Elise Jacobson, LICSW
- Social Worker
- Leominster, MA
National Provider Identifier
1790133478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 117928
- Practice address
- 40 Spruce St
Leominster, MA 01453-3361 - Phone
- (857) 972-3757
- NPI assigned
- Jun 2, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 117928 | MA | Primary |
Addresses
Primary practice location
40 Spruce St
Leominster, MA 01453-3361
Mailing address
40 Spruce St
Leominster, MA 01453-3361
Phone (857) 972-3757
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 |
|---|---|---|---|
| 117928 | MA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464825600000",
"number": "1790133478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 SPRUCE ST",
"city": "LEOMINSTER",
"state": "MA",
"postal_code": "014533361",
"telephone_number": "857-972-3757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 SPRUCE ST",
"city": "LEOMINSTER",
"state": "MA",
"postal_code": "014533361",
"telephone_number": "857-972-3757"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBSON",
"first_name": "ELISE",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-02",
"last_updated": "2016-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MA",
"license": "117928",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Leominster, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.