Individual provider Active NPI

Jacob Andrew Beuerlein, LPCC

  • Professional Counselor
  • Cincinnati, OH
National Provider Identifier
1225416357
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.1700271 Issued in OH
Practice address
830 Ezzard Charles Dr
Cincinnati, OH 45214-2525
Phone
(513) 381-6672
Fax
(513) 381-6086
NPI assigned
May 8, 2015
Last updated
Apr 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C.1400053 OH
Professional Counselor 101YP2500X E.1700271 OH Primary

Addresses

Primary practice location

830 Ezzard Charles Dr
Cincinnati, OH 45214-2525

Mailing address

830 Ezzard Charles Dr
Cincinnati, OH 45214-2525
Phone (513) 381-6672

Other practice location 1

4968 Glenway Ave
Cincinnati, OH 45238-3902
Phone (513) 853-6575 ext. 1839

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C.1400053OHMDMental Health Counselor
E.1700271OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Addiction Treatment Past Accepting new patients
Center for Addiction Treatment Past Accepting new patients
Center for Addiction Treatment Past Accepting new patients

Organizations & group practices 3

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": "1431043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1225416357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 EZZARD CHARLES DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452142525",
            "telephone_number": "513-381-6672",
            "fax_number": "513-381-6086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 EZZARD CHARLES DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452142525",
            "telephone_number": "513-381-6672",
            "fax_number": "513-381-6086"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4968 Glenway Ave",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452383902",
            "country_code": "US",
            "telephone_number": "513-853-6575 x1839",
            "fax_number": "513-853-6587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEUERLEIN",
        "first_name": "JACOB",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-08",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.1400053",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.1700271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; 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.