JESSIE K JACOBS (LICSW) – Clinical Social Worker, NPI 1417652009

JESSIE K JACOBS (LICSW) is a healthcare provider. based in Decatur, Alabama. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 5308C (AL). The NPI Number for JESSIE K JACOBS (LICSW) is 1417652009

Main info

Female
Sole Proprietor
7 Years Of Experience
Accepts Medicare Assignment
Name
JESSIE K JACOBS (LICSW)
NPI
1417652009
Phone
(662) 231-8485
Address
115 Sage Oak Dr
Enumeration Date
3 April 2023
Last Update Date
30 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2563410811
Graduation Year
2019 (7 years ago)
PAC ID
4587103544
Group Practice PAC ID
6608108824
Professional Enrollment ID
I20240822002164
Address ID
AL356010004DE206XXSEXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

390 CLINICAL SOCIAL WORKER in AL

Provider Addresses for JESSIE K JACOBS (LICSW)

  • 115 Sage Oak Dr

    Decatur, AL 356037523

    Phone: (662) 231-8485

    Type: Location

  • 115 SAGE OAK DR

    DECATUR, AL 356037523

    Phone: (662) 231-8485

    Type: Mailing

  • 206 4TH AVE SE

    DECATUR, AL 356012531

    Phone: (256) 341-0811

    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: 2024-08-22

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
I20240822002164IClinical 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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 35603)

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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: 6608108824View full group profile
NameSpecialtyState
-AL
-AL
Mental Health CounselorAL
Mental Health CounselorAL
Clinical Social WorkerAL
Mental Health CounselorAL
Clinical Social WorkerAL

Reviews

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Frequently asked questions

What number should I use to identify JESSIE K JACOBS (LICSW) for billing?
Administrative and clinical systems typically use NPI 1417652009 for JESSIE K JACOBS (LICSW).
Should I treat JESSIE K JACOBS (LICSW) as an active provider?
Patients and plans typically see JESSIE K JACOBS (LICSW) as active in the national extract.
What type of care does JESSIE K JACOBS (LICSW) provide?
JESSIE K JACOBS (LICSW)'s profile centers on Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Is JESSIE K JACOBS (LICSW) tied to Decatur, Alabama?
If you are local to Decatur, Alabama, JESSIE K JACOBS (LICSW) may be relevant to your search.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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