Jason Edward Chandler, MS, LPCC-S, LICDC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

E.2202902-SUPV Issued in OH

Practice address

422 W Loveland Ave
Loveland, OH 45140-2322

Phone

(513) 334-7272

Fax

(513) 676-0051

NPI assigned

Mar 17, 2020

Last updated

Mar 22, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 29, 2024 through Mar 29, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Self Care Counseling Inc

  • Mental Health Counselor
  • Loveland, OH
  • NPI 1578387809
  NPD Authorized official
• Self Care Counseling Inc

  • Mental Health Counselor
  • Loveland, OH
  • NPI 1942968011

  Addiction (Substance Use Disorder)

  NPD Authorized official

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

{
    "created_epoch": "1584403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1083240550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 W LOVELAND AVE",
            "city": "LOVELAND",
            "state": "OH",
            "postal_code": "451402322",
            "telephone_number": "513-334-7272",
            "fax_number": "513-676-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 W LOVELAND AVE",
            "city": "LOVELAND",
            "state": "OH",
            "postal_code": "451402322",
            "telephone_number": "513-334-7272",
            "fax_number": "513-676-0051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19904 Augusta Dr Ste 3",
            "address_purpose": "LOCATION",
            "city": "Lawrenceburg",
            "state": "IN",
            "postal_code": "470257549",
            "country_code": "US",
            "telephone_number": "513-334-7272",
            "fax_number": "513-676-0051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANDLER",
        "first_name": "JASON",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "MS, LPCC-S, LICDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-17",
        "last_updated": "2024-03-22",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.162169",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39004679A",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.2202902-SUPV",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2202902-SUPV",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "6185268",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0479064",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE PROVIDER NUMBER",
            "identifier": "CS2223800174",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300084117",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• David Arthur Chapin, BA, LCDCIII
• Tajee Childers-Whitfield, LPC
• Christine Jeffer DPM, LLC (ProActive Foot Care)
• CHS - Goshen, Inc. (Venetian Gardens)

• Mental Health Counselor in Loveland, OH
• Providers in Loveland, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.