Individual provider Active NPI

Jack A Breegle, LPCC-S

  • Professional Counselor
  • Niles, OH
National Provider Identifier
1043691496
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
165 E Park Ave
Niles, OH 44446-2352
Phone
(330) 544-8005
Fax
(330) 544-9379
NPI assigned
Jun 11, 2015
Last updated
Apr 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

165 E Park Ave
Niles, OH 44446-2352

Mailing address

4191 Claridge Dr
Youngstown, OH 44511-1009
Phone (330) 257-0851

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cadence Care Network CurrentSince Apr 13, 2025 Accepting new patients
Cadence Care Network CurrentSince Apr 13, 2025 Accepting new patients

Locations

165 E Park Ave
Niles, OH 44446
Phone (330) 544-8005

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1043691496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4191 CLARIDGE DR",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445111009",
            "telephone_number": "330-257-0851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 E PARK AVE",
            "city": "NILES",
            "state": "OH",
            "postal_code": "444462352",
            "telephone_number": "330-544-8005",
            "fax_number": "330-544-9379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREEGLE",
        "first_name": "JACK",
        "middle_name": "A",
        "credential": "LPCC-S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-11",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.