Lisa Jacobson LCSW LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

LISA JACOBSON LCSW LLC

Practice address

2529 S Kelly Ave Ste C
Edmond, OK 73013-2976

Phone

(405) 467-0894

Fax

(405) 562-1975

NPI assigned

Oct 5, 2023

Organization subpart

No

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

Authorized official

Name

Lisa M Jacobson, LCSWNPI 1922024363

Title

Counselor

Phone

(307) 680-4154

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa M Jacobson, LCSW

  • Clinical Social Worker
  • Edmond, OK
  • NPI 1922024363
  NPD Authorized official

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

{
    "created_epoch": "1696464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696464000000",
    "number": "1952181992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 FLINT RIDGE RD",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730032481",
            "telephone_number": "307-680-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2529 S KELLY AVE STE C",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730132976",
            "telephone_number": "405-467-0894",
            "fax_number": "405-562-1975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA JACOBSON LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-05",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "307-680-4154",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Edmond, OK
• Providers in Edmond, OK by specialty
• Clinical Social Worker in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.