Amanda Jerger, LPCC-S

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E.2404056-SUPV Issued in OH

Practice address

1018 Ralston Ave
Defiance, OH 43512-5312

Phone

(419) 567-2138

Fax

(419) 225-8878

NPI assigned

Aug 24, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mandy Jerger Other name

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

Medicare enrollment (NPD)

Enrolled

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.

• Shalom Ministries

  dba Shalom Counseling & Mediation Center

  • Community/Behavioral Health Agency
  • Archbold, OH
  • NPI 1366573552
  Medicare reassignment NPD
• Joy D Fruchey and Associates

  • Clinical Social Worker
  • Wauseon, OH
  • NPI 1710625306
  Medicare reassignment

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

{
    "created_epoch": "1535068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784505600000",
    "number": "1801377122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 N WEST ST",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458014332",
            "telephone_number": "419-221-3072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 RALSTON AVE",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435125312",
            "telephone_number": "419-567-2138",
            "fax_number": "419-225-8878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERGER",
        "first_name": "AMANDA",
        "credential": "LPCC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-24",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2404056-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0312677",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANDY",
            "last_name": "JERGER",
            "credential": "LPCC-S",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Professional Counselor in Defiance, OH
• Providers in Defiance, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.