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GRACE K JACOBSON PSYD
NPI 1750920443
Psychologist - Clinical in Astoria, OR

Active since December 30, 2019Opted out of Medicare · through Apr 2, 2028
1 12TH ST STE 208, ASTORIA, OR 97103(503) 470-1520(503) 470-1191 Get Directions Write a Review

NPPES record last updated: January 9, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 9, 2023, Dec 30, 2019 (2 updates tracked since 2019).

About Grace K Jacobson Psyd NPPES

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

GRACE K JACOBSON PSYD (NPI 1750920443) is an individual clinical provider in Astoria, Oregon, licensed in Minnesota (LP6492) and active in the NPI registry since December 2019. She has opted out of Medicare through April 2, 2028.

NPPES Registry Identity

NPI1750920443
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameGRACE K JACOBSONCredential: PSYD
Location Address1 12TH ST STE 208Astoria, OR 97103-4146
Mailing Address1 12th St Ste 208Astoria, OR 97103-4146 · (503) 470-1520 · Fax (503) 470-1191
Phone(503) 470-1520
Fax(503) 470-1191
Sole ProprietorNo
Enumeration DateDecember 30, 2019
Last NPPES UpdateJanuary 9, 20232 updates tracked since enumeration
NPPES CertifiedJanuary 9, 2023
✔ NPI 1750920443 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in MN · LP6492
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
1 12TH ST STE 208, Astoria, OR 97103
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Oregon.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Grace K Jacobson Psyd 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 April 2, 2024 through April 2, 2028.

Opt-Out Effective DateApril 2, 2024
Opt-Out In Effect ThroughApril 2, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97103 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
$166.64 typical visit price
range $54.96 – $166.64
Typical copayment $41.66 (range $13.74 – $41.66)
Most-billed visit code 99205
Established Patient
$97.16 typical visit price
range $17.68 – $136.19
Typical copayment $24.29 (range $4.42 – $34.04)
Most-billed visit code 99214
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 2

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

SARAH BARRETT LPC, CADC I, CCTP
Counselor (Mental Health)
1 12TH ST STE 208
ASTORIA, OR 97103
Clatsop County (971) 704-2484
COURAGE PSYCHOTHERAPY, LLC
Clinic/Center (Mental Health (Including Community Mental Health Center))
1 12TH ST STE 208
ASTORIA, OR 97103
Clatsop County (503) 470-1520

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 Grace Jacobson's NPI number?

The NPI number for Grace Jacobson is 1750920443. It was assigned to this individual provider in the NPPES registry on December 30, 2019.

Where is Grace Jacobson located?

Grace Jacobson practices at 1 12th St Ste 208, Astoria, OR 97103. The listed phone number is (503) 470-1520.

What is Grace Jacobson's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Grace Jacobson enrolled in Medicare?

No. Grace Jacobson has opted out of Medicare through April 2, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Grace Jacobson accept?

Health plans from BridgeSpan Health Company and Regence BlueCross BlueShield of Oregon list Grace Jacobson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Grace Jacobson was last updated on January 9, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.