Individual provider Active NPI

Jessica L Douglas, LPC

  • Counselor
  • Wooster, OH
National Provider Identifier
1639945975
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
C.2405858 Issued in OH
Practice address
2000 Noble Dr
Wooster, OH 44691-5353
Phone
(330) 264-3232
NPI assigned
Nov 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2405858 OH
Prevention Professional 405300000X RA.163860 OH
Counselor 101Y00000X C.2405858 OH Primary

Addresses

Primary practice location

2000 Noble Dr
Wooster, OH 44691-5353

Mailing address

2000 Noble Dr
Wooster, OH 44691-5353
Phone (330) 264-3232

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C.2405858OHMDCounselor
2405858OHMDProfessional Counselor
RA.163860OHMDPrevention Professional

Practice roles

OrganizationSpecialtyStatusNew patients
Guernsey Health Choices, Inc. PastSince Dec 1, 2023 Accepting new patients
Guernsey Health Choices, Inc. PastSince Dec 1, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1639945975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 NOBLE DR",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446915353",
            "telephone_number": "330-264-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 NOBLE DR",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446915353",
            "telephone_number": "330-264-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-28",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "2405858",
            "primary": false
        },
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": "OH",
            "license": "RA.163860",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "C.2405858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2025; 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.