MARK JACOB (LCSW) – Counseling Psychologist, NPI 1245285295

MARK JACOB (LCSW) is a healthcare provider. based in Decatur, Alabama. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 1081C (AL). The NPI Number for MARK JACOB (LCSW) is 1245285295

Main info

Male
34 Years Of Experience
Accepts Medicare Assignment
Name
MARK JACOB (LCSW)
NPI
1245285295
Phone
(256) 822-2375
Address
16 MOULTON ST E
Enumeration Date
24 May 2006
Last Update Date
25 January 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2568222375
Graduation Year
1992 (34 years ago)
PAC ID
2668401506
Group Practice PAC ID
2769789551
Professional Enrollment ID
I20050810000942
Address ID
AL356012515DE251XXSEXX402
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience69
Completeness75
Years active:20State licenses:1Digital endpointsOther names

390 CLINICAL SOCIAL WORKER in AL

Provider Addresses for MARK JACOB (LCSW)

  • 16 MOULTON ST E

    DECATUR, AL 356012310

    Phone: (256) 822-2375

    Type: Mailing

  • 251 JOHNSTON ST SE STE 100

    DECATUR, AL 356012515

    Phone: (256) 822-2375

    Type: Location

  • 2868, Acton Road, Vestavia Hills, Jefferson County, Alabama, 35243, United States

    BIRMINGHAM, AL 35243

    Phone: (205) 968-8360

    Fax: (205) 968-8373

    Type: Mailing

  • 801, Church Street, Decatur, DeKalb County, Georgia, 30030, United States

    SUITE 1

    DECATUR, AL 35602

    Phone: (256) 355-4461

    Fax: (256) 355-4370

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-08-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050810000942IClinical Social WorkerALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour9415$0
View full utilization report →

Insurance plans in this area (ZIP 35601)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2769789551View full group profile
NameSpecialtyState
Clinical Social WorkerVA
Mental Health CounselorAL
Mental Health CounselorAL
Mental Health CounselorAL
Mental Health CounselorAL
Mental Health CounselorWA
Clinical Social WorkerAL
Mental Health CounselorAL
Mental Health CounselorAL
Clinical Social WorkerAL

Reviews

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Frequently asked questions

How is MARK JACOB (LCSW) identified in CMS data?
CMS-hosted NPPES data lists MARK JACOB (LCSW) with NPI 1245285295.
Is MARK JACOB (LCSW) listed as active for patients and plans?
The listing shows MARK JACOB (LCSW) as active in the NPI system.
What is MARK JACOB (LCSW)'s specialty?
The listing groups MARK JACOB (LCSW) with Counseling Psychologist. Clinical services aligned with this taxonomy classification.
What address line appears for MARK JACOB (LCSW)?
MARK JACOB (LCSW)'s geographic hint is Decatur, Alabama in our summary view.
Why does MARK JACOB (LCSW) have multiple addresses?
5 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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