Jacques Pelser, LPCC-S, LIDCD

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E.1901301-SUPV Issued in OH

Practice address

1680 Nave Rd SE
Massillon, OH 44646-9604

Phone

(330) 830-8740

Fax

(330) 830-0912

NPI assigned

Mar 2, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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.

• Resiliency & Recovery Counseling Center LLC

  • Mental Health Counselor
  • Massillon, OH
  • NPI 1518659408
  NPD Authorized official

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

{
    "created_epoch": "1456876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1306206487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 CLEVELAND AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447021805",
            "telephone_number": "330-455-0374",
            "fax_number": "330-453-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 NAVE RD SE",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446469604",
            "telephone_number": "330-830-8740",
            "fax_number": "330-830-0912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELSER",
        "first_name": "JACQUES",
        "credential": "LPCC-S, LIDCD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-02",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.161995",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.1901301-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0266616",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Massillon, OH
• Providers in Massillon, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.