Brianna Kaitlin Jacobs

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A15585 Issued in NC

Practice address

5 Centerview Dr Ste 110
Greensboro, NC 27407-3709

Phone

(336) 455-1305

NPI assigned

Mar 4, 2020

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Psychological Healthcare, PLLC

  • Professional Counselor
  • Syracuse, NY
  • NPI 1922109578
  NPD (past)

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

{
    "created_epoch": "1583280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1942835665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3640 BELMONT ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274064948",
            "telephone_number": "336-455-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 CENTERVIEW DR STE 110",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274073709",
            "telephone_number": "336-455-1305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "BRIANNA",
        "middle_name": "KAITLIN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-04",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A15585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Katherine Jackson, LCMHC, NCC
• Vera Mae Jackson
• Sera L Jacob, MD
• Anna Victoria Jacobs, PA
• Bret Charles Jacobs, D.O.
• Caitlin Megan Jacobs, FNP-C
• Daniel Patrick Jacobs, MD
• Kristen Taylor Jacobsen, OD
• Anyela Jacome Ceron
• Sam Jacubowitz, MD

• Mental Health Counselor in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; 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.