MARY CASEY JACOB (NPI# 1083612246) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083612246 |
| Entity Type | Individual |
| Full Name | MARY CASEY JACOB |
| Credential | PH.D. |
| Practice Address |
263 Farmington Ave Farmington CT 06030-0001 |
| Mailing Address |
263 Farmington Ave Provider Enrollment Farmington CT 06030-2212 |
| Practice Telephone | 8606794550 |
| Practice Fax Number | 8606791845 |
| Mailing Telephone | 8606797503 |
| Mailing Fax Number | 8606791610 |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2014-02-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 001621 | CT | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 1083612246 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518425982 | Mary Deena Jacob | Nurse Practitioner | 2865 Mcdermott Rd #225, Plano, TX 75025 | 2019-03-05 |
| 1124537667 | Mary Jacob | Dentist | 334 Broadway, Revere, MA 02151-5016 | 2017-09-27 |
| 1164774071 | Mary Jacob | Pharmacist | 16 S Waukegan Rd, Deerfield, IL 60015-5216 | 2012-10-03 |
| 1225321755 | Mary Sunny Jacob | Emergency Medicine | 2150 Pennsylvania Ave Nw, Washington, DC 20037-3201 | 2011-05-17 |
| 1194741041 | Mary Ann Jacob | Pediatrics | 2841 Debarr Rd, Suite 45, Anchorage, AK 99508-2932 | 2006-07-14 |
| 1396776571 | Mary R Jacob | Clinical Nurse Specialist | 1600 S Orlando Ave, Winter Park, FL 32789-5547 | 2006-07-05 |
| 1659348399 | Mary Anne Jacob | Obstetrics & Gynecology | 6545 France Avenue South, Suite 540, Edina, MN 55435 | 2006-03-01 |
| Street Address |
263 FARMINGTON AVE |
| City | FARMINGTON |
| State | CT |
| Zip Code | 06030-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609879519 | Michael Joseph Giordano | Neurological Surgery | 263 Farmington Ave, Farmington, CT 06030-0001 | 2005-05-24 |
| 1891394995 | Ewa Jaszczolt | Nurse Practitioner | 263 Farmington Ave, Farmington, CT 06030-0001 | 2020-10-20 |
| 1295333458 | Brianne Catherine Bischoff | Nurse Practitioner | 263 Farmington Ave, Farmington, CT 06030-0001 | 2020-10-10 |
| 1023622073 | Michael John Arciszewski | Perfusionist | 263 Farmington Ave, Farmington, CT 06030-0002 | 2020-09-06 |
| 1073126199 | Esha Bhatt | Student in an Organized Health Care Education/Training Program | 263 Farmington Ave, Farmington, CT 06032-1956 | 2020-08-28 |
| 1689286932 | Margaret Darin | Physician Assistant | 263 Farmington Ave, Farmington, CT 06030-0001 | 2020-08-18 |
| 1174133656 | Rosa Raquel Huivin | Student in an Organized Health Care Education/Training Program | 263 Farmington Ave, Farmington, CT 06030-0001 | 2020-08-09 |
| 1336758051 | Sahar Zamani | Student in an Organized Health Care Education/Training Program | 263 Farmington Ave, Farmington, CT 06030-0002 | 2020-07-28 |
| 1083222954 | Gabriela Maria Parra | Student in an Organized Health Care Education/Training Program | 263 Farmington Ave, Farmington, CT 06030-0001 | 2020-07-16 |
| 1780292680 | Bastian Andres Rojas Espinoza | Student in an Organized Health Care Education/Training Program | 263 Farmington Ave, Farmington, CT 06030-0001 | 2020-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821617606 | David Wozny | Student in an Organized Health Care Education/Training Program | General Medicine Clinic, Outpatient Pavillion-2 East, 263 Farmington Ave, Farmington, CT 06030 | 2020-04-13 |
| 1508495185 | Zachary Boivin | Student in an Organized Health Care Education/Training Program | Emergency Medicine Office, 263 Farmington Ave, Farmington, CT 06030 | 2020-04-06 |
| 1063903730 | Agura Afiari | Student in an Organized Health Care Education/Training Program | Uconn School of Medicine, 263 Farmington Avenue, Farmington, CT 06030 | 2018-05-29 |
| 1750879474 | Areeba Siddiqui | Student in an Organized Health Care Education/Training Program | 263 Farmington Avenue Mc1921, Farmington, CT 06030 | 2018-04-27 |
| 1508362013 | Arya Saniee I | Student in an Organized Health Care Education/Training Program | 264 Farmington Ave, Farmington, CT 06030 | 2018-04-03 |
| 1679828594 | Randall Morera | Student in an Organized Health Care Education/Training Program | 262 Farmington Ave, Farmington, CT 06030 | 2012-07-17 |
| 1750644365 | Ugonna Ijeoma | Student in an Organized Health Care Education/Training Program | 260 Farmington Ave, Farmington, CT 06030 | 2012-06-19 |
| 1407018419 | Julia Marie Toto | Plastic Surgery | University Physicians, 263 Farmington Avenue, Farmington, CT 06030 | 2008-06-30 |
| 1851456495 | Jeffrey Gross | Anesthesiology | 263 Farmington Avenue, Mc-2015, John Dempsey Hospital, Farmington, CT 06030 | 2006-12-26 |
| 1649225269 | Julian Nieves | Internal Medicine | 263 Famrington Avenue, Farmington, CT 06030 | 2006-05-23 |
| Find all providers in zip 06030 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578062295 | Megan Maureen Clarke | Psychologist | 3 Forest Park Dr Ste 101, Farmington, CT 06032-1468 | 2018-02-08 |
| 1023324316 | Faith Prelli | Psychologist | 304 Main St Ste 413, Farmington, CT 06032-2985 | 2010-08-24 |
| 1508098211 | Linda Lee Sutton Meade | Psychologist | 1016 W Columbia St, Sex Offender Rehabilitation and Treatment Services, Farmington, MO 63640-2902 | 2009-08-13 |
| 1760670962 | Emily Young Bullock | Psychologist | 240 N East Promontory Ste 200, Farmington, UT 84025-2950 | 2007-10-12 |
| 1295883353 | James Merrill Wood | Psychologist | 23629 Liberty St, Farmington, MI 48335-3568 | 2007-01-08 |
| 1083612477 | Julian Ford | Psychologist | 10 Talcott Notch, Farmington, CT 06030-0001 | 2005-07-11 |
| 1366939191 | Wellspring Psychological Services, LLC | Psychologist | 3 Forest Park Dr Ste 101, Farmington, CT 06032-1468 | 2018-04-17 |
| 1528568110 | Lynn Joy Mcmunn | Psychologist | 270 Farmington Ave Ste 309, Farmington, CT 06032-1953 | 2018-02-20 |
| 1275925117 | Onik Integrative Medicine | Psychologist | 3300 N Butler Ave, Suite 216, Farmington, NM 87401-5621 | 2015-03-02 |
| 1255762951 | John Paulino | Psychologist | 1400a E 20th St, Farmington, NM 87401-9024 | 2013-12-05 |
| Find all providers in FARMINGTON | ||||
| City | FARMINGTON |
| Zip Code | 06030 |
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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.