Active NPI
Jackelyn Marie Lucas
- Addiction (Substance Use Disorder) Counselor
- Springfield, OH
National Provider Identifier
1770381287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- LCDCII.161835
- Practice address
- 106 E. Main St.
Springfield, OH 45503 - Phone
- (937) 284-0744
- NPI assigned
- Mar 3, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LCDCII.161835 | OH | Primary |
Addresses
Primary practice location
106 E. Main St.
Springfield, OH 45503
Mailing address
310 Union St Apt 109
Yellow Springs, OH 45387-2033
Phone (937) 321-6564
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 |
|---|---|---|---|
| LCDCII.161835 | 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": "1740960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740960000000",
"number": "1770381287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "310 UNION ST APT 109",
"city": "YELLOW SPRINGS",
"state": "OH",
"postal_code": "453872033",
"telephone_number": "937-321-6564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 E. MAIN ST.",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "45503",
"telephone_number": "937-284-0744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCAS",
"first_name": "JACKELYN",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-03-03",
"last_updated": "2025-03-03",
"certification_date": "2025-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "LCDCII.161835",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.