MS. TIRZAH D JACOB MA LPC CADC I NPI 1669497467

NPI Information

NPI: 1669497467
Provider Name: MS. TIRZAH D JACOB, MA, LPC, CADC I
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
4729 NE 50TH PL
PORTLAND, OR
ZIP 97218
Phone: (503) 407-9232
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MS. Tirzah D Jacob, MA, LPC, CADC I is a professional counselor in Portland, OR. MS. Tirzah D Jacob, MA, LPC, CADC I NPI is 1669497467. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4729 NE 50TH PL
PORTLAND, OR
ZIP 97218-009
Phone: (503) 407-9232

The enumeration date for this NPI number is 7/13/2006 and was last updated on 11/12/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	02-11-44	OREGON	No
2	101YM0800X	Counselor	Mental Health	C1780	OREGON	No
3	101YP2500X	Counselor	Professional	C1780	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	500601179	MEDICAID	OREGON
2	11607801	OTHER	OREGON	CAQH
3	1265740096	OTHER	OREGON	BFHLPC
4	C1780	OTHER	OREGON	STATE LICENSE
5	030027	OTHER	OREGON	OAID
6	02-11-44	OTHER	OREGON	CERTIFIED DRUG/ALCOHOL COUNSELOR LEVEL I

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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