Jacob D Crosby, LISW, LICDC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.2304680-SUPV Issued in OH

Practice address

6140 S Broadway
Lorain, OH 44053-3821

Phone

(440) 233-7232

Fax

(440) 233-9070

NPI assigned

Feb 28, 2017

Last updated

May 28, 2025By the provider in NPPES

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

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

Clinical Social Worker

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Riveon Mental Health and Recovery

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lorain, OH
  • NPI 1841268281
  Medicare reassignment
• Bellefaire JCB

  • Children's Substance Abuse Rehabilitation Facility
  • Elyria, OH
  • NPI 1376802249
  NPD (past)

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

{
    "created_epoch": "1488240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1508306382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6140 S BROADWAY",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440533821",
            "telephone_number": "440-233-7232",
            "fax_number": "440-246-4930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6140 S BROADWAY",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440533821",
            "telephone_number": "440-233-7232",
            "fax_number": "440-233-9070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSBY",
        "first_name": "JACOB",
        "middle_name": "D",
        "credential": "LISW, LICDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-28",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.162822",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2304680-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Crespo Alvarez
• Kayleigh Crocker, SW
• Joanna Crockett, QMHS BA
• Deandre Crook
• Pamela Elayne Crook, L.P.N.
• Mary Jane Croston
• Carol Crow, LPC
• Caitlin Lee Crowell, PA
• Elaine M Crumb, RN
• Alyssa Crundwell, QMHS BA

• Clinical Social Worker in Lorain, OH
• Providers in Lorain, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; 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.