Kaitlyn Raeme Jacobsen, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

1535 42ND St S Ste 400
Fargo, ND 58103-3383

Phone

(701) 715-3183

NPI assigned

Sep 30, 2019

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

Enrolled in ND

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Creative Spirit Counseling PLLCGroup PAC ID 8527492966, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Creative Spirit Counseling, PLLC

  • Clinical Social Worker
  • Fargo, ND
  • NPI 1134779176
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1962043026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 CINNAMON RIDGE PL",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580788190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 42ND ST S STE 400",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033383",
            "telephone_number": "701-715-3183"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2701 13th Ave S",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581033602",
            "country_code": "US",
            "telephone_number": "701-234-3620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "KAITLYN",
        "middle_name": "RAEME",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-30",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Jacobs
• Johannes Jacobus Jacobs, MD
• Katie Jo Jacobs, PA
• Whitney Marie Jacobs, PT, DPT
• David Scott Jacobsen, RT (R)(CT)
• Jacobson Family Dental PLLC
• Anthony James Jacobson, DDS
• David A. Jacobson, MD
• Eric Scott Jacobson, MD
• Jamie Jacobson, PHARM D

• Clinical Social Worker in Fargo, ND
• Providers in Fargo, ND by specialty
• Clinical Social Worker in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; 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.