Jacob Ryan Cerrillo
Individual provider Active NPI Mental Health Counselor · Stroudsburg, PA
NPI 1821882192 · NPPES record last updated Apr 9, 2025
Key facts
- NPI
- 1821882192
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 919 Main St FL 1
Stroudsburg, PA 18360-1603 - Phone
- (570) 534-0324
- NPI assigned
- Apr 9, 2025
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Lotus Counseling & Consulting Services | Mental Health | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
919 Main St FL 1
Stroudsburg, PA 18360-1603
Mailing address
919 Main St FL 1
Stroudsburg, PA 18360-1603
Phone (570) 534-0324
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All providers in Stroudsburg, PA · Mental Health Counselor in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 9, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.