Active NPIIndividual providerSole proprietor

Mrs. Lara I Jacobs, MS, CCC-SLP

Speech-Language Pathologist, in Maplewood, New Jersey

NPI Number1225587686
Practice location
23 Hoffman St, Maplewood, NJ 07040-1113
Fax
—
Last updated
September 27, 2016

Lara Ilysse Jacobs is a Speech-Language Pathologist, based in Maplewood, NJ. Lara Ilysse Jacobs practices in Maplewood, NJ and has the professional credentials of MS, CCC-SLP. The NPI Number for Lara Ilysse Jacobs is 1225587686 and holds a License No. 41YS00600100 (NJ). The current practice location address for Lara Ilysse Jacobs is 23 Hoffman St, Maplewood, NJ 07040-1113 and can be reached out via phone at 212-851-6231.

Provider Profile Details

NPI Number
1225587686
Provider Name
Lara Ilysse Jacobs
Credential
MS, CCC-SLP
Provider Entity Type
Individual
Gender
Female
Address
23 Hoffman St, Maplewood, NJ 07040-1113
Phone Number
212-851-6231
Primary Taxonomy
Speech-Language Pathologist, · 235Z00000X
Sole Proprietor
Yes
Provider Enumeration Date
September 27, 2016
Last Update Date
September 27, 2016
NPI Status
Active

Provider Business Practice Location Address Details

Address
23 Hoffman St
Maplewood, NJ 07040-1113
Zip
07040-1113
Phone Number
212-851-6231
Maplewood, NJ 07040Get directions →

Provider Business Mailing Address Details

Address
23 Hoffman St
Maplewood, NJ 07040-1113
City
Maplewood
State
NJ
Zip
07040-1113
Phone Number
212-851-6231

License Information

License Number
41YS00600100
License State
NJ
Taxonomy
Speech-Language Pathologist, · 235Z00000X · Primary

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

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Frequently Asked Questions

What is the NPI number of Mrs. Lara I Jacobs, MS, CCC-SLP?

The NPI number of Mrs. Lara I Jacobs, MS, CCC-SLP is 1225587686. It was assigned on September 27, 2016 and is currently active in the NPPES registry.

What is the specialty of Mrs. Lara I Jacobs, MS, CCC-SLP?

Mrs. Lara I Jacobs, MS, CCC-SLP is registered under the primary taxonomy Speech-Language Pathologist, (code 235Z00000X), licensed in NJ under license number 41YS00600100.

Where does Mrs. Lara I Jacobs, MS, CCC-SLP practice?

The practice location is 23 Hoffman St, Maplewood, NJ 07040-1113. The office can be reached at 212-851-6231 (phone).

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1225587686 directly on the NPPES registry website.

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