Lukose Jacob, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW11962 Issued in FL

Practice address

200 SW 62ND Blvd
Gainesville, FL 32607-2083

Phone

(352) 376-8211

Fax

(352) 373-7594

NPI assigned

Feb 6, 2007

Sex

Male

Sole proprietor

No

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

Enrolled in FL

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, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

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.

• Meridian Behavioral Healthcare, Inc.

  • Community/Behavioral Health Agency
  • Gainesville, FL
  • NPI 1134287154
  Medicare reassignment NPD
• North Florida Assessment and Counseling Inc

  • Professional Counselor
  • Jacksonville, FL
  • NPI 1508978867

  Clinical

  Medicare reassignment NPD
• Trenton Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Trenton, FL
  • NPI 1801826268
  Medicare reassignment NPD
• Meridian Behavioral Healthcare, Inc of Lake City

  • Community/Behavioral Health Agency
  • Lake City, FL
  • NPI 1689846859
  NPD
• Meridian Behavioral Healthcare, Inc.

  • Community/Behavioral Health Agency
  • Ocala, FL
  • NPI 1033850797
  NPD
• Trenton Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Chiefland, FL
  • NPI 1336399260
  NPD
• Trenton Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fleming Island, FL
  • NPI 1275220238
  NPD
• Trenton Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Gainesville, FL
  • NPI 1740513928
  NPD (past)

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1912046640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7108 SW 80TH TER DEPT OF",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326088412",
            "telephone_number": "352-327-0293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SW 62ND BLVD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326072083",
            "telephone_number": "352-376-8211",
            "fax_number": "352-373-7594"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7765 S County Road 231",
            "address_purpose": "LOCATION",
            "city": "Lake Butler",
            "state": "FL",
            "postal_code": "320545721",
            "country_code": "US",
            "telephone_number": "386-496-6000 x6486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOB",
        "first_name": "LUKOSE",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sha'Tundria Jackson
• Shalyon Jackson
• Shantavia Jackson
• Tina Shanette Jackson
• Kevin Jacob, DO
• Nadia Diana Jacob
• R Patrick Jacob, MD
• Benjamin Norman Jacobs, M.D.
• Brian P Jacobs
• Ciara Jacobs

• Clinical Social Worker in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2025; 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.