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MS. THERESA JACOB LPC
NPI 1215097944
Counselor - Professional in Herndon, VA

Active since December 11, 2006Opted out of Medicare · through Nov 15, 2026
297 HERNDON PKWY, STE. 202, HERNDON, VA 20170(703) 481-6130 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Ms. Theresa Jacob Lpc NPPES

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

MS. THERESA JACOB LPC (NPI 1215097944) is an individual professional provider in Herndon, Virginia, licensed in Virginia (0701002593) and active in the NPI registry since December 2006. She has opted out of Medicare through November 15, 2026.

NPPES Registry Identity

NPI1215097944
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMS. THERESA JACOBCredential: LPC
Location Address297 HERNDON PKWY, STE. 202Herndon, VA 20170-4474
Mailing Address297 Herndon Pkwy, Ste. 202Herndon, VA 20170-4474 · (703) 481-6130
Phone(703) 481-6130
Sole ProprietorYes
Enumeration DateDecember 11, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1215097944 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in VA · 0701002593
297 HERNDON PKWY, Herndon, VA 20170
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Ms. Theresa Jacob Lpc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from November 15, 2024 through November 15, 2026.

Opt-Out Effective DateNovember 15, 2024
Opt-Out In Effect ThroughNovember 15, 2026Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 4

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

MEG WALLACE LPC
Counselor (Professional)
297 HERNDON PKWY, SUITE 201
HERNDON, VA 20170
Fairfax County (703) 435-4325
NORTHERN VIRGINIA PSYCHOTHERAPY ASSOC., INC.
Social Worker (Clinical)
297 HERNDON PKWY, STE. 201
HERNDON, VA 20170
Fairfax County (703) 742-6043
DR. CAROLINE M. TAN M.D.
Psychiatry & Neurology (Child & Adolescent Psychiatry)
297 HERNDON PKWY, SUITE 202
HERNDON, VA 20170
Fairfax County (571) 323-3300
KATHI WHITTEN LCSW
Social Worker (Clinical)
297 HERNDON PKWY, STE 201
HERNDON, VA 20170
Fairfax County (703) 742-6043

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 Theresa Jacob's NPI number?

The NPI number for Theresa Jacob is 1215097944. It was assigned to this individual provider in the NPPES registry on December 11, 2006.

Where is Theresa Jacob located?

Theresa Jacob practices at 297 Herndon Pkwy Ste. 202, Herndon, VA 20170. The listed phone number is (703) 481-6130.

What is Theresa Jacob's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Theresa Jacob enrolled in Medicare?

No. Theresa Jacob has opted out of Medicare through November 15, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Theresa Jacob was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.