Mara Robyn Jacobs, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701005391 Issued in VA

Practice address

4850 Mark Center Dr
Alexandria, VA 22311-1882

Phone

(703) 746-3400

Fax

(703) 746-3584

NPI assigned

Jul 8, 2013

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in DC

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• City of Alexandria

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Alexandria, VA
  • NPI 1447279658

  DC

  Medicare reassignment

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

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1891136883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 MARK CENTER DR",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223111882",
            "telephone_number": "703-746-3400",
            "fax_number": "703-746-3584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 MARK CENTER DR",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223111882",
            "telephone_number": "703-746-3400",
            "fax_number": "703-746-3584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "MARA",
        "middle_name": "ROBYN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-08",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701005391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447279658",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lawrence Phillip Jackson III
• Makeda Jackson, OTD, OTR/L
• Marsha E Jackson, CNM
• Shakina Virlee Jackson
• Verline Jackson
• Peyton Jacobs
• Jacqueline Guevara LLC
• Jacqueline M Brideau, PLLC Dba Bloom and Grow Pediatric Physical Therapy
• Lauren R Jaeger
• Darrell Franklin Jagoe Jr.

• Professional Counselor in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.