SHAWNA JACOB (NPI# 1104485929) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104485929 |
Entity Type | Individual |
Full Name | SHAWNA JACOB |
Credential | PHD |
Practice Address |
4805 Montgomery Rd Ste 210 Cincinnati OH 45212-2280 |
Mailing Address |
4805 Montgomery Rd Ste 150 Cincinnati OH 45212-2280 |
Practice Telephone | 5137918080 |
Mailing Telephone | 5139615558 |
Enumeration Date | 2019-06-06 |
Last Update Date | 2019-06-06 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103G00000X | Clinical Neuropsychologist | P.07800 | OH | Behavioral Health & Social Service Providers |
Street Address |
4805 MONTGOMERY RD STE 210 |
City | CINCINNATI |
State | OH |
Zip Code | 45212-2280 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689622532 | Sheri Wirtz | Psychologist | 4805 Montgomery Rd Ste 210, Cincinnati, OH 45212-2280 | 2006-05-04 |
1316588403 | Jenna Del Favero | Nurse Practitioner | 4805 Montgomery Rd Ste 210, Cincinnati, OH 45212-2280 | 2019-10-01 |
1841711876 | Rachel O'brien | Nurse Practitioner | 4805 Montgomery Rd Ste 210, Cincinnati, OH 45212-2280 | 2017-06-29 |
1083654875 | Yannick Grenier | Neurological Surgery | 4805 Montgomery Rd Ste 210, Cincinnati, OH 45212-2280 | 2006-06-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013568930 | Kelly Diane Weber | Social Worker | Va Behavioral Health and Wellness Center, 4600 Smith Road, Norwood, OH 45212 | 2019-09-23 |
1629566039 | Jessica Lee Eckstein | Nurse Practitioner | 4805 Montgomery Rd Ste 154, Cincinnati, OH 45212 | 2018-05-01 |
1578092847 | Kerry Ellen Ragland | Counselor | 2300 Wall Street, Cincinnati, OH 45212 | 2017-06-08 |
1912256454 | Helen Virginia Blackshire | Occupational Therapy Assistant | 4750 Wesley Avenue Suite J, Cincinnati, OH 45212 | 2012-08-30 |
1902154933 | Shelby Davis Lewis | Social Worker | 4750 Wesley Avenue, Suite J, Cincinnati, OH 45212 | 2012-08-23 |
1366727133 | Kelly Gray | Pharmacist | 4605 Montgomery Road, Norwood, OH 45212 | 2011-10-12 |
1588981351 | Stephen M Zitelli | Family Medicine | 1775 Lexington Ave, Cincinnati, OH 45212 | 2010-05-03 |
1699952416 | David William Barr | Marriage & Family Therapist | 4301 Smith Road, Cincinnati, OH 45212 | 2008-01-23 |
1780704718 | Douglas A Dix | Dentist | 5451 Montgomery Road, Cincinnati, OH 45212 | 2007-03-31 |
1376615104 | Orthopedic Diagnostic & Treatment Ctr Inc | Orthopaedic Surgery | 4600 Smith Road, Suite B, Norwood, OH 45212 | 2006-11-15 |
Find all providers in zip 45212 |
Taxonomy Code | 103G00000X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Clinical Neuropsychologist |
An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780072561 | Jessica A Macdonald | Clinical Neuropsychologist | 8000 5 Mile Rd Ste 330, Cincinnati, OH 45230 | 2015-01-02 |
1023041829 | Anna W Byars | Clinical Neuropsychologist | 3333 Burnet Ave, Ml 2015, Cincinnati, OH 45229-3026 | 2006-07-08 |
1205863966 | John J. Barrett | Clinical Neuropsychologist | 3800 Victory Parkway, Cincinnati, OH 45207-6511 | 2006-06-27 |
1962066183 | Rachael Polter | Clinical Neuropsychologist | 151 W Galbraith Rd, Cincinnati, OH 45216-1015 | 2019-04-23 |
1669964029 | Thea Loraine Quinton | Clinical Neuropsychologist | 3333 Burnet Ave # Mlc3015, Cincinnati, OH 45229-3026 | 2018-06-01 |
1871016634 | Audrey Rae Greene | Clinical Neuropsychologist | 4805 Montgomery Rd, Cincinnati, OH 45212-2198 | 2017-07-24 |
1669871851 | Katherine Theresa Baum | Clinical Neuropsychologist | 3333 Burnet Ave, Ml 3015, Cincinnati, OH 45229-3026 | 2014-08-14 |
1770999252 | Sheena Horning | Clinical Neuropsychologist | 234 Goodman St, Cincinnati, OH 45219-2364 | 2014-07-07 |
1063840494 | Kalika Kelkar | Clinical Neuropsychologist | 3200 Vine St, Cincinnati, OH 45220-2213 | 2013-10-22 |
1245530138 | Johnna Devoto | Clinical Neuropsychologist | 222 Piedmont Ave, Suite 3200, Cincinnati, OH 45219-2485 | 2010-10-26 |
Find all providers in CINCINNATI |
City | CINCINNATI |
Zip Code | 45212 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.