Jacob'S Well Counseling Center Inc

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

JACOB'S WELL COUNSELING CENTER INC

Practice address

3340 Lineville Rd
Green Bay, WI 54313-7237

Phone

(920) 562-6236

NPI assigned

Aug 2, 2023

Organization subpart

No

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

Authorized official

Name

Grace Ghost

Title

Administrator

Phone

(920) 931-2531

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gretchen Dominowski, LPC-IT, SAC-IT

  • Mental Health Counselor
  • Menasha, WI
  • NPI 1598381659
  Medicare reassignment Care Compare group NPD
• Erin Luttschwager, MA, LPC, NCC

  • Professional Counselor
  • Green Bay, WI
  • NPI 1861122665
  Medicare reassignment Care Compare group NPD
• Bruce J. Robertson, PHD

  • Psychologist
  • Green Bay, WI
  • NPI 1396770434
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1690934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745280000000",
    "number": "1609558485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 LINEVILLE RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543137237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 LINEVILLE RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543137237",
            "telephone_number": "920-562-6236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOB'S WELL COUNSELING CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-02",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A",
        "authorized_official_last_name": "GHOST",
        "authorized_official_first_name": "GRACE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "920-931-2531"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Alan Jackimowicz, OT
• Lorraine Helena Mary Jackson, MD
• Peter Allen Jackson, PHARMD
• Shawn E Jackson, P.T.
• Andrew Jacob, DDS
• Jacob'S Well Presbyterian Church
• Colleen Jacobe, RN
• Jacobs Well Presbyterian Churcha
• Emily Laura Jacobson
• Martin A Jacobson, DC

• Professional Counselor in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.