Jacqueline Marie Sturbaum, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E2202758 Issued in OH

Practice address

6401 Jaycox Rd
North Ridgeville, OH 44039-1611

Phone

(440) 327-1800

Fax

(440) 327-1533

NPI assigned

Jul 22, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Mental Health Counselor

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kenneth a Deluca PHD and Associates IncGroup PAC ID 2860469160, 15 clinicians

Practice addresses (Care Compare)

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.

• Kenneth a. de Luca,PH.D. & Associates, Inc.

  • Psychologist
  • North Ridgeville, OH
  • NPI 1821018698
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1374451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1497197370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 JAYCOX RD",
            "city": "NORTH RIDGEVILLE",
            "state": "OH",
            "postal_code": "440391611",
            "telephone_number": "440-327-1800",
            "fax_number": "440-327-1533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 JAYCOX RD",
            "city": "NORTH RIDGEVILLE",
            "state": "OH",
            "postal_code": "440391611",
            "telephone_number": "440-327-1800",
            "fax_number": "440-327-1533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STURBAUM",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-22",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E2202758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in North Ridgeville, OH
• Providers in North Ridgeville, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.