Melissa W. Jacob, L.C.S.W

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

005167 Issued in CT

Practice address

1129 Essex PL
Stratford, CT 06615-5850

Phone

(203) 375-8140

Fax

(203) 375-8050

NPI assigned

Apr 3, 2006

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

Other identifiers 3

Other names 1

• Melissa Wilson Jacob Former name

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1992767347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 ESSEX PL",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066155867",
            "telephone_number": "203-257-8140",
            "fax_number": "203-375-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 ESSEX PL",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066155850",
            "telephone_number": "203-375-8140",
            "fax_number": "203-375-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "MELISSA",
        "middle_name": "W.",
        "credential": "L.C.S.W",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "005167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "279269",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "140005167CT02",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004247096",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "JACOB",
            "middle_name": "WILSON",
            "credential": "L.C.S.W",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• J. Cayo Counseling, LLC
• David G Jacob, L.C.S.W
• Joseph Jarmon
• Jennifer M. Lockshier LLC
• Kizzy Kai Jeter-Wilcox, MSW
• John C Britz DDS PC
• Benjamin Johnson III

• Clinical Social Worker in Stratford, CT
• Providers in Stratford, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.