Active NPI
Jacob Spencer
- Addiction (Substance Use Disorder) Counselor
- Ironton, OH
National Provider Identifier
1750139812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CDCA.187510
- Practice address
- 401 Center St FRNT B
Ironton, OH 45638-1519 - Phone
- (740) 479-5135
- NPI assigned
- May 13, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA.187510 | OH | Primary |
| Case Manager/Care Coordinator | 171M00000X | OH |
Addresses
Primary practice location
401 Center St FRNT B
Ironton, OH 45638-1519
Mailing address
401 Center St FRNT B
Ironton, OH 45638-1519
Phone (740) 479-5135
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
| License | State | Type | Specialty |
|---|---|---|---|
| CDCA.187510 | OH | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715558400000",
"number": "1750139812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 CENTER ST FRNT B",
"city": "IRONTON",
"state": "OH",
"postal_code": "456381519",
"telephone_number": "740-479-5135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 CENTER ST FRNT B",
"city": "IRONTON",
"state": "OH",
"postal_code": "456381519",
"telephone_number": "740-479-5135"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPENCER",
"first_name": "JACOB",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-05-13",
"last_updated": "2024-05-13",
"certification_date": "2024-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "CDCA.187510",
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "OH",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ironton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.