Kristine M Jacobs, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8333-123 Issued in WI

Practice address

8800 Washington Ave
Suite 100
Mount Pleasant, WI 53406-3701

Phone

(262) 633-3591

Fax

(262) 633-2619

NPI assigned

Aug 23, 2016

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 names 1

• Kristine Michels Former name

Medicare fee-for-service enrollment

Enrolled in WI

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 1

Specialty

Clinical Social Worker

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cornerstone Counseling Services IncGroup PAC ID 1456256023, 338 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Cornerstone Counseling Services, Inc

  • Mental Health Counselor
  • Brookfield, WI
  • NPI 1033127246
  Medicare reassignment Care Compare group NPD
• Children'S Service Society of Wisconsin

  • Clinical Social Worker
  • Mount Pleasant, WI
  • NPI 1548434848
  NPD (past)

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

{
    "created_epoch": "1471910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1861947574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "MS 958",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-7615",
            "fax_number": "414-266-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8800 WASHINGTON AVE",
            "address_2": "SUITE 100",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534063701",
            "telephone_number": "262-633-3591",
            "fax_number": "262-633-2619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "KRISTINE",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-23",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8333-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINE",
            "last_name": "MICHELS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Impact Child and Family Therapies Inc
• Integrity of Care Afh
• Integrity Senior Health
• J Harris Homes Inc
• J P Irelan Endodontics LLC
• Saloni Jaiswal
• Danielle L James
• Aaron Paul Janes, D.D.S.
• Tyler Jankiewicz, DPT
• Kari Janusheske, LPC

• Clinical Social Worker in Mount Pleasant, WI
• Providers in Mount Pleasant, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2016; 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.