MS. JACQUELINE A JACOBSON (L.P.C.) – Mental Health Counselor, NPI 1487648085
Mental Health Counselor
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,998 MENTAL HEALTH COUNSELOR in VA
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Provider Addresses for MS. JACQUELINE A JACOBSON (L.P.C.)
10721, Main Street, Fairfax, Virginia, 22030, United States
SUITE 2350
FAIRFAX, VA 220306914
Phone: (703) 591-5912
Fax: (703) 591-7210
Type: Mailing
10721 Main St
Suite 2350
Fairfax, VA 220306914
Phone: (703) 591-5912
Fax: (703) 591-7210
Type: Location
3700 JOSEPH SIEWICK DR STE 408A
FAIRFAX, VA 220331745
Phone: (703) 620-3211
Fax: (703) 620-3215
Type: Mailing
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: 2024-12-11
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20241211001133 | I | Mental Health Counselor | DC | TBD |
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.
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 22030)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| N E U R O L O G Y | HI | |
| H E M A T O L O G Y | WA | |
| - | VIR | |
| - | IL | |
| Orthopedic Surgery | VA | |
| - | VA | |
| Diagnostic Radiology | VA | |
| General Surgery | CT | |
| - | VA | |
| N E U R O S U R G E R Y | VA |
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