Individual provider Active NPI

Jeffrey Edward Drake, LPCC

  • Professional Counselor
  • Worthington, OH
National Provider Identifier
1134589807
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.2203119 Issued in OH
Practice address
544 Riley Ave
Worthington, OH 43085-3087
Phone
(614) 906-8505
NPI assigned
Feb 24, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E.2203119 OH Primary
Counselor 101Y00000X C.1000369 OH

Addresses

Primary practice location

544 Riley Ave
Worthington, OH 43085-3087

Mailing address

544 Riley Ave
Worthington, OH 43085-3087
Phone (614) 906-8505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240111004489 OH Practitioner - Mental Health Counselor 2466803630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Counseling Source IncGroup PAC ID 6709772387, 51 clinicians

Practice addresses (Care Compare)

10921 Reed Hartman Hwy
Suite 133
Blue Ash, OH 45242-2851
Phone (513) 984-9838

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.1000369OHMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Source Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

10921 Reed Hartman Hwy
Ste 133
Blue Ash, OH 45242
Phone (513) 984-9838

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1456272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1134589807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "544 RILEY AVE",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430853087",
            "telephone_number": "614-906-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "544 RILEY AVE",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430853087",
            "telephone_number": "614-906-8505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "JEFFREY",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-24",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2203119",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "C.1000369",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worthington, OH

Sources for this page

Verify at the official NPI Registry.