Individual provider Active NPI

Jessica Renee Tubbs, LISW-S, LICDC

  • Social Worker
  • Cincinnati, OH
National Provider Identifier
1457712747
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
I.2203754-SUPV Issued in OH
Practice address
2600 Victory Pkwy
Cincinnati, OH 45206-1711
Phone
(513) 761-6222
Fax
(513) 679-4590
NPI assigned
Mar 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LICDC.161929 OH
Social Worker 104100000X I.2203754-SUPV OH Primary

Addresses

Primary practice location

2600 Victory Pkwy
Cincinnati, OH 45206-1711

Mailing address

2600 Victory Pkwy
Cincinnati, OH 45206-1711

Medicare participation

Medicare enrollment files
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CDCA.131626OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Gateways Recovery Inc CurrentSince Jul 15, 2022 Accepting new patients
Talbert House Past Accepting new patients
Gateways Recovery Past Accepting new patients

Locations

4966 Glenway Ave
Cincinnati, OH 45238
Phone (513) 242-7164

2621 Victory Pkwy
Cincinnati, OH 45206
Phone (513) 221-4673

2600 Victory Pkwy
Cincinnati, OH 45206
Phone (513) 872-5863

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1457913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1457712747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 VICTORY PKWY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452061711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 VICTORY PKWY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452061711",
            "telephone_number": "513-761-6222",
            "fax_number": "513-679-4590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUBBS",
        "first_name": "JESSICA",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "LISW-S, LICDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-14",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.161929",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I.2203754-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.