Individual provider Active NPI

Jefferson D Collier, LPC

  • Professional Counselor
  • Wooster, OH
National Provider Identifier
1376093989
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.1901178-SUPV Issued in OH
Practice address
2000 Noble Dr
Wooster, OH 44691-5353
Phone
(330) 264-3232
NPI assigned
Oct 6, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E.1901178-SUPV OH Primary
Mental Health Counselor 101YM0800X C.1300645 OH

Addresses

Primary practice location

2000 Noble Dr
Wooster, OH 44691-5353

Mailing address

2500 John Glenn Hwy
Cambridge, OH 43725-9028
Phone (740) 439-4428

Other practice location 1

2500 John Glenn Hwy
Cambridge, OH 43725-9028
Phone (740) 439-4428

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

LicenseStateTypeSpecialty
C.1300645OHMDMental Health Counselor
E.1901178-SUPVOHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Village Network Past Accepting new patients

Organizations & group practices 1

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": "1475712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1376093989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 JOHN GLENN HWY",
            "city": "CAMBRIDGE",
            "state": "OH",
            "postal_code": "437259028",
            "telephone_number": "740-439-4428",
            "fax_number": "740-588-6452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 NOBLE DR",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446915353",
            "telephone_number": "330-264-3232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 John Glenn Hwy",
            "address_purpose": "LOCATION",
            "city": "Cambridge",
            "state": "OH",
            "postal_code": "437259028",
            "country_code": "US",
            "telephone_number": "740-439-4428",
            "fax_number": "740-588-6452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLIER",
        "first_name": "JEFFERSON",
        "middle_name": "D",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-06",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.1901178-SUPV",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.1300645",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.