MRS. CANDICE LEE JACOBS (NPI# 1609432004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609432004 |
| Entity Type | Individual |
| Full Name | MRS. CANDICE LEE JACOBS |
| Credential | CDC I |
| Practice Address |
398 West C Street and West Willow Tok AK 99780-0398 |
| Mailing Address |
Po Box 398 Tok AK 99780-0398 |
| Practice Telephone | 9078835106 |
| Practice Fax Number | 9078835108 |
| Mailing Telephone | 9078835106 |
| Mailing Fax Number | 9078835108 |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2019-05-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
AK | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306222658 | Candice Marie Jacobs | Pharmacist | 206 S Wall St, Carbondale, IL 62901-3023 | 2015-08-09 |
| Street Address |
398 WEST C STREET AND WEST WILLOW |
| City | TOK |
| State | AK |
| Zip Code | 99780-0398 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215538681 | Kory Labbe | Counselor | 124 Tok Cut Off, Tok, AK 99780 | 2020-11-03 |
| 1396350633 | Tanana Chiefs Confenerce | Pharmacy | Mile 124.4 Glenn Highway, Tok, Ak, AK 99780 | 2020-09-14 |
| 1780294934 | Charmaine Shay Isaac | Counselor | Tetlin Health Clinic, Tetlin, AK 99780 | 2020-08-03 |
| 1770128811 | Tanana Chiefs Conference | Community/Behavioral Health | West Willow and C Street, Tok, AK 99780 | 2019-11-13 |
| 1588227920 | Joetta Lynn Thompson Colquette | Counselor | West C Street and Willow, Tok, AK 99780 | 2019-04-22 |
| 1093245144 | Mariah Craig | Community Health Worker | Mile 5.9 Mentasta Spur Road, Mentasta Lake, AK 99780 | 2017-06-12 |
| 1881070258 | Arron Atchley | Technician | 204 East Chene Way, Tok, AK 99780 | 2015-08-07 |
| 1881079705 | Francine Lee | Registered Nurse | 1314 Alaska Hwy, Tok, AK 99780 | 2015-07-21 |
| 1265856306 | Ashley Sawyer | Driver | Mp 1314 Alaska Highway, Tok, AK 99780 | 2014-02-10 |
| 1932536877 | Alberta David | Community Health Worker | 123 Tok Cut Off Road, Tok, AK 99780 | 2013-10-10 |
| Find all providers in zip 99780 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083902019 | Marianne Young | Counselor | 204 East Chena Way, Tok, AK 99780 | 2011-07-12 |
| 1760779912 | Charlene A Cleary | Counselor | Mile 123 Tok Cut Off, Tok, AK 99780-0083 | 2011-07-07 |
| 1235452798 | Joni Emma Young | Counselor | 123 Tok Cut Off, Tok, AK 99780 | 2010-03-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962003830 | Lauren Marie Bennett | Counselor | 1170 Marsh Laurel Ave, North Pole, AK 99705-5969 | 2020-11-05 |
| 1285234419 | Amanda Paulette Gannon | Counselor | 201 Deermount St Fl 2, Ketchikan, AK 99901-6649 | 2020-10-27 |
| 1740889351 | Deborah Diane Merritt | Counselor | 362 Tyee St, Soldotna, AK 99669-7631 | 2020-10-23 |
| 1295334993 | Terria Jean Vandenhuerk | Counselor | 7125 Old Seward Hwy Ste 201, Anchorage, AK 99518-2282 | 2020-10-22 |
| 1588261630 | Maia Stack | Counselor | 222 Tongass Dr Bldg 1206, Sitka, AK 99835-9416 | 2020-10-01 |
| 1518572387 | Morgan Dwyer | Counselor | 51310 Timber Bay Ct, Homer, AK 99603 | 2020-09-09 |
| 1104438365 | Jalon Alexander Mccullough | Counselor | 542 4th Ave Ste B-101, Fairbanks, AK 99701-4707 | 2020-08-19 |
| 1346859824 | John George Hetrick | Counselor | 51310 Timber Bay Ct., Homer, AK 99603 | 2020-07-30 |
| 1285251397 | Elmer Eugene Johnson | Counselor | 184 Cityview Ave, Homer, AK 99603-7017 | 2020-07-06 |
| 1710504774 | Magen Marie Spencer | Counselor | 410 River Front Street, Nenana, AK 99760-0159 | 2020-06-25 |
| Find all providers with the same taxonomy | ||||
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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.