Jacob J Elliott, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

260 Issued in OH

Practice address

5600 Monroe St Ste 201a
Sylvania, OH 43560-2775

Phone

(419) 885-1910

Fax

(419) 885-5060

NPI assigned

Oct 4, 2005

Sex

Male

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

Clinical Psychologist

Education

Other, 1964

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Elliott & Associates Inc

  • Mental Health Counselor
  • Sylvania, OH
  • NPI 1710974035
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1629065701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 MONROE ST STE 201A",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602775",
            "telephone_number": "419-885-1910",
            "fax_number": "419-885-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 MONROE ST STE 201A",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602775",
            "telephone_number": "419-885-1910",
            "fax_number": "419-885-5060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "JACOB",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer L Ellegood, P.A.
• Alex Blair Ellenberger, MD
• Audrey Erlene Ellenwood, PH.D.
• Sandra J Elliot, LPCC
• Elliott & Associates Inc
• Christine D Ellis, M.D.
• Alison Ellithorpe, AU.D.
• Ahmed G. Elsayed, M.D.
• Marna Elzinga, OTR/L
• Kelly Emch, MD

• Psychologist in Sylvania, OH
• Providers in Sylvania, OH by specialty
• Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.