Jacob M Soudah

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

186292 Issued in OH

Practice address

246 E Campus View Blvd
Columbus, OH 43235-4634

Phone

(614) 505-3126

NPI assigned

Nov 6, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1063285658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2875 OLENTANGY RIVER RD APT 610",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432023514",
            "telephone_number": "614-772-3517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 E CAMPUS VIEW BLVD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432354634",
            "telephone_number": "614-505-3126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUDAH",
        "first_name": "JACOB",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "186292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosa Soto
• Verita Soto, RN
• John Sotos
• John P Sotos, MD
• Wiley W Souba, MD
• Grace Elizabeth Soufleris, NP-C
• Alexander-Jacques Theodore Sougiannis, MD, PHD
• Taryne Soukup, CT
• Trenton Soukup, PHARMACIST
• Soul Express Transportatin LLC

• Addiction (Substance Use Disorder) Counselor in Columbus, OH
• Providers in Columbus, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.