Active NPI
Katelyn Jakobsen, LCMHC
- Professional Counselor
- Cary, NC
National Provider Identifier
1902385396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 15293
- Practice address
- 2500 Regency Pkwy Ste 124
Cary, NC 27518-8549 - Phone
- (919) 228-9807
- NPI assigned
- Aug 7, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Professional Counselor | 101YP2500X | 15293 | NC | Primary |
Addresses
Primary practice location
2500 Regency Pkwy Ste 124
Cary, NC 27518-8549
Mailing address
7736 Calcutta Dr
Willow Spring, NC 27592-7489
Phone (708) 415-5311
Other practice location 1
547 Keisler Dr Ste 202
Cary, NC 27518-9309
Phone (919) 454-4450
Other practice location 2
1431 N Claremont Ave Fl 2
Chicago, IL 60622-1702
Phone (312) 633-5890
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 8, 2024 through Jan 8, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15293 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716508800000",
"number": "1902385396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7736 CALCUTTA DR",
"city": "WILLOW SPRING",
"state": "NC",
"postal_code": "275927489",
"telephone_number": "708-415-5311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 REGENCY PKWY STE 124",
"city": "CARY",
"state": "NC",
"postal_code": "275188549",
"telephone_number": "919-228-9807"
}
],
"practiceLocations": [
{
"address_1": "547 Keisler Dr Ste 202",
"address_purpose": "LOCATION",
"city": "Cary",
"state": "NC",
"postal_code": "275189309",
"country_code": "US",
"telephone_number": "919-454-4450",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1431 N Claremont Ave Fl 2",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606221702",
"country_code": "US",
"telephone_number": "312-633-5890",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JAKOBSEN",
"first_name": "KATELYN",
"credential": "LCMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-07",
"last_updated": "2024-05-24",
"certification_date": "2024-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "15293",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cary, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.