Jacob Louis Spehar, MA, LPCC, LADC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC01722 Issued in MN

Practice address

155 Lake St S Ste 102
Forest Lake, MN 55025-2604

Phone

(651) 461-1438

NPI assigned

Mar 15, 2018

Last updated

Mar 4, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacob.spehar.p21@direct.painphysicians.nextgenshare.com

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.

• Spehar Guiding LLC

  • Mental Health Counselor
  • Forest Lake, MN
  • NPI 1558139014
  NPD Authorized official
• Midwest Center for Personal & Family Development PA

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Paul, MN
  • NPI 1285730903
  NPD (past)
• Pathway Virtu-Health

  • Family Nurse Practitioner
  • Shoreview, MN
  • NPI 1073134284
  NPD (past)

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

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1639672694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5824 213TH ST N",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550259745",
            "telephone_number": "651-226-7906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 LAKE ST S STE 102",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550252604",
            "telephone_number": "651-461-1438"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5824 213th St N",
            "address_purpose": "LOCATION",
            "city": "Forest Lake",
            "state": "MN",
            "postal_code": "550259745",
            "country_code": "US",
            "telephone_number": "651-226-7906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPEHAR",
        "first_name": "JACOB",
        "middle_name": "LOUIS",
        "credential": "MA, LPCC, LADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-15",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303864",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC01722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Jeanne Slavik, LPC, LAMFT
• Kristin J Somsky, R.PH.
• Niels H Sorensen, MD
• Catherine Lynn Sparboe, RDN
• Spehar Guiding LLC
• Heidi Marie Spetzman, LAMFT
• Diane Marie Spiess, PTA
• St. Croix Endodontics
• Charlotte Louise Stack, R.N., CNS
• William Howard Stackpole, DDS

• Mental Health Counselor in Forest Lake, MN
• Providers in Forest Lake, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.