Jackolyn Marie Van Horn, M.ED, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

E.2404325-SUPV Issued in OH

Practice address

611 High St NW
Carrollton, OH 44615-1117

Phone

(330) 627-3954

Fax

(330) 627-3984

NPI assigned

May 13, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeast IncGroup PAC ID 8426014853, 48 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

State licenses

Practice roles

Locations

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.

• Southeast, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Columbus, OH
  • NPI 1932169497
  Medicare reassignment Care Compare group NPD
• Southeast, Inc

  • Federally Qualified Health Center (FQHC)
  • Mount Gilead, OH
  • NPI 1114893203
  NPD

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

{
    "created_epoch": "1589328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1245852276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 HIGH ST NW",
            "city": "CARROLLTON",
            "state": "OH",
            "postal_code": "446151117",
            "telephone_number": "330-627-3954",
            "fax_number": "330-627-3984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 HIGH ST NW",
            "city": "CARROLLTON",
            "state": "OH",
            "postal_code": "446151117",
            "telephone_number": "330-627-3954",
            "fax_number": "330-627-3984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN HORN",
        "first_name": "JACKOLYN",
        "middle_name": "MARIE",
        "credential": "M.ED, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-13",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.2404325-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judy Talbott
• Michelle Tangler
• Bobbie Jo Tinlin
• Sonja Trbovich
• Mary Ullman
• Weslee Warner, LPCC
• Sarah Watkins, MS CCC-SLP
• Michael Watt
• Wendy Danielle Wiley, FNP-C
• Linda Carol Wilson, L.I.S.W.

• Mental Health Counselor in Carrollton, OH
• Providers in Carrollton, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.