Individual provider Active NPI

Jacob R. Stotler

  • Mental Health Counselor
  • Kearney, NE
National Provider Identifier
1285252791
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3296 Issued in NE
Practice address
221 W 44TH St Ste 1
Kearney, NE 68845-2484
Phone
(307) 677-1618
NPI assigned
Jul 10, 2020
Last updated
Jun 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2187 WY
Mental Health Counselor 101YM0800X 3296 NE Primary
Professional Counselor 101YP2500X 2187 WY

Addresses

Primary practice location

221 W 44TH St Ste 1
Kearney, NE 68845-2484

Mailing address

221 W 44TH St Ste 1
Kearney, NE 68845-2484
Phone (308) 627-9076

Other practice location 1

2526 Seymour Ave
Cheyenne, WY 82001-3159
Phone (307) 634-9653

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20240910000718 NE Practitioner - Mental Health Counselor 5799225330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

221 W 44TH St
Suite 1
Kearney, NE 68845-2484
Phone (308) 627-9076

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2187WYMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Monty Shultz Counseling & Neurofeedback LLC Mental Health CurrentSince Mar 16, 2021 Accepting new patients
Wyone Mental Health, LLC Mental Health CurrentSince Jul 6, 2024 Accepting new patients
McDowell Counseling & Associates, LLC Mental Health CurrentSince Feb 12, 2023 Accepting new patients

Locations

124 W 25th St
Ste B4
Kearney, NE 68847
Phone (308) 627-4743

2002 Central Ave
Kearney, NE 68847
Phone (308) 440-2817

221 W 44th St
Ste 1
Kearney, NE 68845
Phone (307) 677-1618

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": "1594339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1285252791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 W 44TH ST STE 1",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688452484",
            "telephone_number": "308-627-9076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W 44TH ST STE 1",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688452484",
            "telephone_number": "307-677-1618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2526 Seymour Ave",
            "address_purpose": "LOCATION",
            "city": "Cheyenne",
            "state": "WY",
            "postal_code": "820013159",
            "country_code": "US",
            "telephone_number": "307-634-9653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOTLER",
        "first_name": "JACOB",
        "middle_name": "R.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-10",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WY",
            "license": "2187",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "3296",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WY",
            "license": "2187",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

Verify at the official NPI Registry.