Garrit Jacobson, CCM

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW66054 Issued in CA

Practice address

15501 San Fernando Mission Blvd
Suite 302
Mission Hills, CA 91345-1359

Phone

(818) 781-5511

NPI assigned

Dec 12, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• LDS Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mission Hills, CA
  • NPI 1225233828
  NPD (past)

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

{
    "created_epoch": "1197417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431388800000",
    "number": "1891978870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4328 KIMBERWICK LN",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930212309",
            "telephone_number": "801-310-4296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15501 SAN FERNANDO MISSION BLVD",
            "address_2": "SUITE 302",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451359",
            "telephone_number": "818-781-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "GARRIT",
        "credential": "CCM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-12",
        "last_updated": "2015-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "7684422-3501",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "36882",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW66054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack Isbell, D.C.
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• Jack O Moreno DDS Inc
• Jenna Jackson, R.D.
• James George Physical Therapy
• Janesri de Silva M.D. a Prof Corp
• Michael Reza Jarahzadeh, MD.
• Ashkan Javaherian, PHARM D.
• Jeff Sung, MD a Medical Corporation

• Clinical Social Worker in Mission Hills, CA
• Providers in Mission Hills, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2015; 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.