MATTHEW ELMO JACOBSON (NPI# 1952672735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952672735 |
| Entity Type | Individual |
| Full Name | MATTHEW ELMO JACOBSON |
| Practice Address |
21360 N 1450 E Moroni UT 84646-0461 |
| Mailing Address |
Po Box 461 Moroni UT 84646-0461 |
| Practice Telephone | 4354455200 |
| Practice Fax Number | 4354455201 |
| Mailing Telephone | 4354455200 |
| Mailing Fax Number | 4354455201 |
| Enumeration Date | 2012-01-25 |
| Last Update Date | 2012-01-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003360991 | Matthew Jacobson | Nurse Practitioner | 108 20th Street, Torrington, WY 82440-2812 | 2016-08-08 |
| 1992161178 | Matthew Jacobson | Physical Therapist | 788 Prince Ave Ste C, Athens, GA 30606-5912 | 2016-01-04 |
| 1346385507 | Matthew David Jacobson | Internal Medicine | Total Care Physicians, Omega Prof Center, Omega Dr., Building B, Suite 89, Newark, DE 19713 | 2007-02-21 |
| 1285832352 | Matthew Jacobson | Counselor | 2415 Se 43rd Ave, Portland, OR 97206-1600 | 2007-07-10 |
| 1285645036 | Matthew Warner Jacobson | Anesthesiology | 1304 Oak St, Melbourne, FL 32901-3111 | 2006-08-10 |
| Street Address |
21360 N 1450 E |
| City | MORONI |
| State | UT |
| Zip Code | 84646-0461 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124328349 | Lance Irons | Counselor | 21360 N 1450 E, Moroni, UT 84646-0383 | 2010-10-22 |
| 1114448362 | Amy Ruth Brown | Counselor | 21360 N 1450 E, Moroni, UT 84646-0461 | 2017-06-28 |
| 1508386608 | Katie Cranford | Counselor | 21360 N 1450 E, Moroni, UT 84646-0461 | 2017-06-21 |
| 1366978827 | Jake Paxman | Counselor | 21360 N 1450 E, Moroni, UT 84646-0461 | 2017-05-03 |
| 1437685906 | Erick Espinoza | Counselor | 21360 N 1450 E, Moroni, UT 84646-0461 | 2017-05-03 |
| 1902354335 | Melyn Lund | Community Health Worker | 21360 N 1450 E, Moroni, UT 84646-0461 | 2016-09-14 |
| 1518319102 | Aubree Bailey | Community Health Worker | 21360 N 1450 E, Moroni, UT 84646-0461 | 2016-07-07 |
| 1699120279 | Rocky Dettamanti | Counselor | 21360 N 1450 E, Moroni, UT 84646-0461 | 2016-05-02 |
| 1407201072 | Alicia Hill | Counselor | 21360 N 1450 E, Moroni, UT 84646-0461 | 2016-05-02 |
| 1417301011 | Jenessa Tuai | Counselor | 21360 N 1450 E, Moroni, UT 84646-0461 | 2016-04-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942727029 | Doug Lloyd Hopes | Counselor | 21630 North 1450 East, Morona, UT 84646 | 2017-08-29 |
| 1881002061 | Compass Academy Transitional Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4800 E 17160 N, Moroni, UT 84646 | 2014-07-31 |
| 1932534260 | Matthew Truman Johnson | Substance Abuse Rehabilitation Facility | 2860 E 19500 N, Moroni, UT 84646 | 2013-09-05 |
| 1457611766 | Samuel Paul Wilkey | Substance Abuse Rehabilitation Facility | 21360 N 1450e, Moroni, UT 84646 | 2012-05-21 |
| 1275828949 | Robert Duane Simonson | Social Worker | 4800 East 17160 North, Moroni, UT 84646 | 2011-06-10 |
| 1386950392 | Josh Wilkey | Community Health Worker | 4800 E. 17160 N, Moroni, UT 84646 | 2010-08-27 |
| 1891007886 | Compass Academy | Residential Treatment Facility, Emotionally Disturbed Children | 4800 E. 17160 N., Moroni, UT 84646 | 2010-07-08 |
| 1518906320 | Eileen Keenan Jackson | Family Medicine | 51 E Main St., Moroni, UT 84646 | 2006-06-06 |
| 1225537707 | Jessica Pay | Counselor | 2860 East 19500 North, Moroni, UT 84646 | 2018-02-09 |
| 1134628613 | Todd Pay | Counselor | 2860 East 19500 North, Moroni, UT 84646 | 2018-02-09 |
| Find all providers in zip 84646 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811354293 | Amy Black | Counselor | 2360 N 1450 E, Moroni, UT 84646-0461 | 2016-01-15 |
| 1154621373 | Ursula Jensen | Counselor | 21260 N 1450 E, Moroni, UT 84646-0383 | 2010-10-22 |
| 1124328349 | Lance Irons | Counselor | 21360 N 1450 E, Moroni, UT 84646-0383 | 2010-10-22 |
| 1538589122 | Cameron Rodgers | Counselor | 21260 N. 1450 E., Moroni, UT 84646 | 2014-04-22 |
| 1912333816 | Pataleone F. Vaha | Counselor | 21260 N. 1450 E., Moroni, UT 84646-0383 | 2013-09-24 |
| 1518393412 | Michael Adams-case | Counselor | 21260 N. 1450 E., Moroni, UT 84646-0383 | 2013-09-24 |
| 1871929778 | Julio C. Tapia Fernandez | Counselor | 21260 N. 1450 E., Moroni, UT 84646-0383 | 2013-09-24 |
| 1255766242 | Brad Anderson | Counselor | 21260 N. 1450 E., Moroni, UT 84646-0383 | 2013-09-09 |
| 1003253444 | Zackary Allred | Counselor | 21260 N. 1450 E., Moroni, UT 84646-0383 | 2013-05-24 |
| 1811334253 | Steven Perkins | Counselor | 21260 N. 1450 E., Moroni, UT 84646-0383 | 2013-05-24 |
| Find all providers in MORONI | ||||
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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.