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MR. JACOB WILDING AVERY LCSW
NPI 1558639989
Social Worker - Clinical in San Diego, CA

Active since December 13, 2011
4258 HAWK ST, SAN DIEGO, CA 92103(619) 727-7167 Get Directions Write a Review

NPPES record last updated: December 13, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Jacob Wilding Avery Lcsw NPPES

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

MR. JACOB WILDING AVERY LCSW (NPI 1558639989) is an individual clinical provider in San Diego, California, licensed in California (27985) and active in the NPI registry since December 2011.

NPPES Registry Identity

NPI1558639989
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. JACOB WILDING AVERYCredential: LCSW
Location Address4258 HAWK STSan Diego, CA 92103-1357
Mailing Address4258 Hawk StSan Diego, CA 92103-1357 · (619) 727-7167
Phone(619) 727-7167
Sole ProprietorYes
Enumeration DateDecember 13, 2011
✔ NPI 1558639989 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 CA · 27985
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.
4258 HAWK ST, San Diego, CA 92103
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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 Jacob Avery's NPI number?

The NPI number for Jacob Avery is 1558639989. It was assigned to this individual provider in the NPPES registry on December 13, 2011.

Where is Jacob Avery located?

Jacob Avery practices at 4258 Hawk St, San Diego, CA 92103. The listed phone number is (619) 727-7167.

What is Jacob Avery's specialty?

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

When was this NPI record last updated?

The NPPES record for Jacob Avery was last updated on December 13, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.