Individual provider Active NPI

James M Staneluis, LPCC LICDC

  • Counselor
  • Maumee, OH
National Provider Identifier
1235206434
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
ICAOC22266 Issued in OH
Practice address
109 W Wayne St
Maumee, OH 43537-2150
Phone
(419) 893-8432
Fax
(419) 891-5403
NPI assigned
Nov 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 976085 OH
Professional Counselor 101YP2500X E0002538 OH
Counselor 101Y00000X ICAOC22266 OH Primary

Addresses

Primary practice location

109 W Wayne St
Maumee, OH 43537-2150

Mailing address

611 W Harrison St
Maumee, OH 43537-2027
Phone (419) 893-8432

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
I20240112003903 OH Practitioner - Mental Health Counselor 3375615859 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acorn Counseling LLCGroup PAC ID 9133290737, 2 clinicians

Practice addresses (Care Compare)

109 W Wayne St
Maumee, OH 43537-2150
Phone (419) 893-8432

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ICAOC22266OHMDCounselor
976085OHMDAddiction (Substance Use Disorder) Counselor
E0002538OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Acorn Counseling LLC CurrentSince Jan 1, 2024 Accepting new patients
Jane Broering Ammons Past Accepting new patients

Locations

109 W Wayne St
Maumee, OH 43537
Phone (419) 893-6841

Organizations & group practices 2

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": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1235206434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W HARRISON ST",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435372027",
            "telephone_number": "419-893-8432",
            "fax_number": "419-891-5403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 W WAYNE ST",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435372150",
            "telephone_number": "419-893-8432",
            "fax_number": "419-891-5403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANELUIS",
        "first_name": "JAMES",
        "middle_name": "M",
        "credential": "LPCC  LICDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "976085",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E0002538",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "ICAOC22266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

Verify at the official NPI Registry.