Deborah Ann Jacob-Johnson, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

6401010898 Issued in MI

Practice address

101 W Loomis St
Suite 206
Ludington, MI 49431-2091

Phone

(231) 845-7809

NPI assigned

Dec 30, 2010

Sex

Female

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Northwest Michigan Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Traverse City, MI
  • NPI 1144645250
  NPD (past)
• Northwest Michigan Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Shelby, MI
  • NPI 1306262258
  NPD (past)

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

{
    "created_epoch": "1293667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293667200000",
    "number": "1891099149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 N FERRY ST",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311321",
            "telephone_number": "231-233-2614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W LOOMIS ST",
            "address_2": "SUITE 206",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494312091",
            "telephone_number": "231-845-7809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB-JOHNSON",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-30",
        "last_updated": "2010-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401010898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Innate Counseling, LLC
• Inner Depth Therapy, PLLC
• Interim Associates
• Internal Medicine Associates of Ludington, PC
• Hailey Jackson, LLBSW
• Amber Jaeb, RN
• James T Ryan D O PLLC
• Kimberly Janicki
• Ella Jarvis
• Marie Agnes Jensen, LMSW

• Counselor in Ludington, MI
• Providers in Ludington, MI by specialty
• Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.