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

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Lotus Counseling & Consulting Services Mental Health Past
since Apr 13, 2025
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in Stroudsburg, PA

All providers in Stroudsburg, PA · Mental Health Counselor in Pennsylvania

Sources for this page

Verify at the official NPI Registry.