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KATELYN IRENE JAKUBOVIC MA, NCC, LPC
NPI 1164033528
Counselor in Philadelphia, PA

Active since August 11, 2020PECOS Enrolled
30 S 15TH ST STE 1550, PHILADELPHIA, PA 19102(724) 804-8591 Get Directions Write a Review

NPPES record last updated: April 24, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Katelyn Irene Jakubovic Ma, Ncc, Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATELYN IRENE JAKUBOVIC MA, NCC, LPC (NPI 1164033528) is an individual counselor in Philadelphia, Pennsylvania, licensed in Pennsylvania (PC012604) and active in the NPI registry since August 2020. She is enrolled in Medicare PECOS and maintains a secondary practice location in Moon Township.

NPPES Registry Identity

NPI1164033528
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameKATELYN IRENE JAKUBOVICCredential: MA, NCC, LPC
Location Address30 S 15TH ST STE 1550Philadelphia, PA 19102-4806
Mailing Address341 Spring StLatrobe, PA 15650-1932 · (724) 771-5810
Phone(724) 804-8591
Sole ProprietorNo
Enumeration DateAugust 11, 2020
Last NPPES UpdateApril 24, 2025
NPPES CertifiedApril 24, 2025
✔ NPI 1164033528 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
License✔ Licensed in PA · PC012604
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
30 S 15TH ST STE 1550, Philadelphia, PA 19102
Open in Google Maps ↗

Secondary Practice Location 1

Location 11010 Brodhead RdMoon Township, PA 15108-2322 · Phone (412) 339-1782

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Katelyn Irene Jakubovic Ma, Ncc, Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Katelyn Jakubovic reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Favored Wellness Counseling And Consulting, LLC
271 mi
Professional
1010 BROADHEAD ROAD, 2ND FLOOR
Moon Township, PA 15108
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 18 clinicians in this Medicare group
NPI 1457986721 (412) 303-1717

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

QUICK & GENTLE STICKS LLC
Technician, Pathology (Phlebotomy)
30 S 15TH ST STE 1550
PHILADELPHIA, PA 19102
Philadelphia County (267) 670-3545
RASHIDAH JACKSON LPN
Licensed Practical Nurse
30 S 15TH ST STE 1550
PHILADELPHIA, PA 19102
Philadelphia County (215) 933-2562
SUSAN FRANKEL SCHIMPF LPC
Counselor (Professional)
30 S 15TH ST STE 1550
PHILADELPHIA, PA 19102
Philadelphia County (215) 948-2802
A FULLER YOU COUNSELING FOR WELLNESS, LLC
Clinic/Center (Mental Health (Including Community Mental Health Center))
30 S 15TH ST STE 1550
PHILADELPHIA, PA 19102
Philadelphia County (484) 318-2207
LYRIKA SMALLS
Technician, Pathology (Phlebotomy)
30 S 15TH ST STE 1550
PHILADELPHIA, PA 19102
Philadelphia County (267) 670-3545
THERESA A SWINTON
Doula
30 S 15TH ST STE 1550
PHILADELPHIA, PA 19102
Philadelphia County (717) 723-8545
LINDSAY GENTINO M.S.
Counselor (Professional)
30 S 15TH ST STE 1550
PHILADELPHIA, PA 19102
Philadelphia County (888) 632-8551
DR. RYAN LUTHER BUHITE PSY. D.
Psychologist (Clinical)
30 S 15TH ST STE 1550, PMB 704308
PHILADELPHIA, PA 19102
Philadelphia County (814) 771-0386

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Katelyn Jakubovic's NPI number?

The NPI number for Katelyn Jakubovic is 1164033528. It was assigned to this individual provider in the NPPES registry on August 11, 2020.

Where is Katelyn Jakubovic located?

Katelyn Jakubovic practices at 30 S 15th St Ste 1550, Philadelphia, PA 19102. The listed phone number is (724) 804-8591.

What is Katelyn Jakubovic's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Is Katelyn Jakubovic enrolled in Medicare?

Yes. Katelyn Jakubovic is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Katelyn Jakubovic's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Katelyn Jakubovic reassigns Medicare benefits to Favored Wellness Counseling And Consulting, LLC (Moon Township, PA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Katelyn Jakubovic's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Katelyn Jakubovic was last updated on April 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.