Active NPI
Jefferson D Collier, LPC
- Professional Counselor
- Wooster, OH
National Provider Identifier
1376093989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- E.1901178-SUPV
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| C.1300645 | OH | MD | Mental Health Counselor |
| E.1901178-SUPV | OH | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Voluntary or Charitable Agency
- Wooster, OH
- NPI 1124057914
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.