Jessica Shamblin, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E.1800905 Issued in OH

Practice address

1501 Madison Rd
Walnut Hills, OH 45206-1706

Phone

(513) 354-5200

Fax

(513) 354-5331

NPI assigned

Jan 13, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Jessica Lytle Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Havens of Ohio LLC

  • Substance Abuse Rehabilitation Facility
  • Dayton, OH
  • NPI 1700290301
  NPD (past)

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

{
    "created_epoch": "1231804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540252800000",
    "number": "1093952004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 MADISON RD",
            "city": "WALNUT HILLS",
            "state": "OH",
            "postal_code": "452061706",
            "telephone_number": "513-354-5200",
            "fax_number": "513-354-3551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 MADISON RD",
            "city": "WALNUT HILLS",
            "state": "OH",
            "postal_code": "452061706",
            "telephone_number": "513-354-5200",
            "fax_number": "513-354-5331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4851 Independence St",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Wheat Ridge",
            "state": "CO",
            "postal_code": "800336715",
            "country_code": "US",
            "telephone_number": "303-425-0300",
            "fax_number": "303-432-5071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAMBLIN",
        "first_name": "JESSICA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-13",
        "last_updated": "2018-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.1800905",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.1200221",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "LYTLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lauren Schulz
• Jacey R Schunk, QMHS BA
• Kyle Scott
• Meghan C Sears
• Peter J Seitanakis
• Michael Shannon, QMHS
• Allison G Sharrock
• Kimberly Cheryl Shelton
• Evan S Shouse
• Tehya S Sidler, QMHS BA

• Professional Counselor in Walnut Hills, OH
• Providers in Walnut Hills, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2018; 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.