SUSAN E JACOBY (NPI# 1184089161) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184089161 |
| Entity Type | Individual |
| Full Name | SUSAN E JACOBY |
| Credential | M.S. LPC |
| Practice Address |
5228 Ne Hoyt St Portland OR 97213-3055 |
| Practice Telephone | 5032151612 |
| Practice Fax Number | 5032156477 |
| Mailing Telephone | 5032151612 |
| Mailing Fax Number | 5032156477 |
| Enumeration Date | 2015-12-17 |
| Last Update Date | 2015-12-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
LPC C0924 | OR | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124050273 | Susan Sloan Jacoby | Nurse Practitioner | 3030 Westchester Ave, Purchase, NY 10577 | 2006-07-07 |
| 1154301133 | Susan Jacoby | Nurse Practitioner | 181 Franklin Health Commons, Farmington, ME 04938-6144 | 2006-01-18 |
| Street Address |
5228 NE HOYT ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97213-3055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528067972 | Andris Antoniskis | Internal Medicine | 5228 Ne Hoyt St, Bldg B, 3rd Floor, Portland, OR 97213-3055 | 2005-07-19 |
| 1639524697 | Providence Health & Services Oregon | Substance Abuse Rehabilitation Facility | 5228 Ne Hoyt St, Building B, Portland, OR 97213-3055 | 2016-04-27 |
| 1083075790 | Kelly Shields-didehbani | Counselor | 5228 Ne Hoyt St, Portland, OR 97213-3055 | 2016-03-09 |
| 1861852899 | Elissa L Starks | Counselor | 5228 Ne Hoyt St, Portland, OR 97213-3055 | 2016-03-03 |
| 1285090365 | Carol Virgillito | Social Worker | 5228 Ne Hoyt St, Building B, Portland, OR 97213-3055 | 2016-01-06 |
| 1992160840 | Joy Birnbach Dunstan | Counselor | 5228 Ne Hoyt St, Building B, Portland, OR 97213-3055 | 2015-12-19 |
| 1982069969 | Loree Sheckels | Counselor | 5228 Ne Hoyt St, Portland, OR 97213-3055 | 2015-12-17 |
| 1801096573 | Emma Laverne Sohriakoff | Counselor | 5228 Ne Hoyt St, Portland, OR 97213-3055 | 2007-07-20 |
| 1598963936 | Providence Health & Services - Oregon | Clinic/Center | 5228 Ne Hoyt St, Bldg B, Portland, OR 97213-3055 | 2007-07-06 |
| 1902931801 | Harmony West | Social Worker | 5228 Ne Hoyt St, Portland, OR 97213-3055 | 2007-02-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831715176 | Darnell Jackie Strong | Social Worker | 435 Ne 78th Ave 'strong Counseling Services', Portland, OR 97213 | 2020-06-23 |
| 1336775907 | Redpoint Physical Therapy and Performance LLC | Physical Therapist | 4200 Ne Flanders St Unit B, Portland, OR 97213 | 2020-03-16 |
| 1801431218 | Denise Dorgan-miller | Occupational Therapy Assistant | Providence Elder Place, 4400 Ne Halsey Suite 200, Portland, OR 97213 | 2019-11-08 |
| 1619435617 | Aspiration of Character Counseling Services, LLC | Counselor | 4424 Ne Glisan St, The Li Wellness Building, Second Floor, Portland, OR 97213 | 2019-03-08 |
| 1578049631 | Credena Health LLC | Pharmacy | 4805 Ne Glisan St Ste 11n321, Portland, OR 97213 | 2018-07-12 |
| 1023507795 | Karissa Lynn Schwartz | Speech-Language Pathologist | Providence Portland Medical Center, 4805 Ne Glisan St, Portland, OR 97213 | 2018-05-08 |
| 1861944506 | James Livingston Taylor | Chiropractor | 5212 Ne Sacremento St., Portland, OR 97213 | 2016-10-28 |
| 1962958520 | Caitlin Turner | Massage Therapist | 4317 Ne Tillamook St., Portland, OR 97213 | 2016-09-01 |
| 1326407008 | Julianna Vermeys | Counselor | 4605 Ne Fremont St., 209a, Portland, OR 97213 | 2016-02-23 |
| 1881059822 | Thomas Michael Barrett | Counselor | 5228 Ne Hoyt St. Bldg. B, Portland, OR 97213 | 2015-12-17 |
| Find all providers in zip 97213 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477163657 | Kevin Charles Reiser | Counselor | 2318 Ne Martin Luther King Blvd, Portland, OR 97212-3715 | 2020-08-03 |
| 1881203628 | Beau Curtiss | Counselor | 7916 Se Foster Rd Ste 203, Portland, OR 97206-4289 | 2020-07-28 |
| 1851916886 | Jonathan Cross | Counselor | 49 Montrose Ave Apt 3, Portland, ME 04103-2442 | 2020-06-16 |
| 1639703960 | Elizabeth Ann Anderson | Counselor | 1820 Sw Vermont St Ste J, Portland, OR 97219-1945 | 2020-02-25 |
| 1194356618 | Deforrest Kwesi Jackson | Counselor | 122 Ne 122nd Ave Ste 200, Portland, OR 97230-2103 | 2020-02-03 |
| 1760012942 | Jesse Decker | Counselor | 7015 N Boston Ave, Portland, OR 97217-5711 | 2020-01-16 |
| 1740829076 | Ryan Christianson | Counselor | 2707 Ne Flanders St, Portland, OR 97232-3159 | 2020-01-03 |
| 1083264477 | Kayla Rose Paris | Counselor | 420 Cumberland Ave, Portland, ME 04101-2823 | 2019-09-17 |
| 1275193260 | Anna Khval | Counselor | 1500 Se 122nd Ave, Portland, OR 97233-1207 | 2019-06-20 |
| 1841855301 | Portland Opioid Health Home | Counselor | 48 Free St., Mezzanine Level, Portland, ME 04101 | 2019-05-09 |
| Find all providers in PORTLAND | ||||
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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.