Active NPI
Jacob Andrew Beuerlein, LPCC
- Professional Counselor
- Cincinnati, OH
National Provider Identifier
1225416357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- E.1700271
- 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, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| C.1400053 | OH | MD | Mental Health Counselor |
| E.1700271 | OH | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Cincinnati, OH
- NPI 1174158869
-
- Substance Abuse Rehabilitation Facility
- Cincinnati, OH
- NPI 1215994249
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Cincinnati, OH
- NPI 1972090843
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.