MARY LOU JACOBSEN MSSW, LICSW
NPI 1295824696
Social Worker - Clinical in Owatonna, MN

Q: What is Mary Jacobsen's NPI number?

The NPI number for Mary Jacobsen is 1295824696. It was assigned to this individual provider in the NPPES registry on October 12, 2006. The provider is also known as Mary Lou Wagoner Mssw, Licsw.

Q: What is Mary Jacobsen's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Mary Jacobsen was last updated on February 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.

Active since October 12, 2006PECOS EnrolledAccepts Medicare Assignment

610 FLORENCE AVE, OWATONNA, MN 55060(507) 451-2630(507) 455-8133 Get Directions Write a Review

NPPES record last updated: February 10, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mary Lou Jacobsen Mssw, Licsw NPPES

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

MARY LOU JACOBSEN MSSW, LICSW (NPI 1295824696) is an individual clinical provider in Owatonna, Minnesota, licensed in Minnesota (8206) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1991).

NPPES Registry Identity

NPI1295824696

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameMARY LOU JACOBSENCredential: MSSW, LICSW

Location Address610 FLORENCE AVEOwatonna, MN 55060-4704

Mailing Address610 Florence AveOwatonna, MN 55060-4704

Phone(507) 451-2630

Fax(507) 455-8133

Sole ProprietorNo

Medical School CMSOtherGraduated 1991

Enumeration DateOctober 12, 2006

Last NPPES UpdateFebruary 10, 2021

NPPES CertifiedFebruary 10, 2021

✔ NPI 1295824696 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in MN · 8206

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

610 FLORENCE AVE, Owatonna, MN 55060

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Other Names 1

Former Name (1)Mary Lou Wagoner Mssw, Licsw

Other Identifiers 5

Medicaid074027600MN

Other118039MN · Ucare

OtherHP20016MN · Health Partners

Other4G504WAMN · Blue Cross Blue Shield

Other62-20365MN · United Behavioral Health

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mary Lou Jacobsen Mssw, Licsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2668445628

PECOS Enrollment IDI20061227000299

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55060 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $56.00 – $168.28

Typical copayment $0.00 (range $14.00 – $42.07)

Most-billed visit code NA

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

ALAN J O'MALLEY-LAURSEN MSW, LICSW

Social Worker (Clinical)