Jacob Kulp Gotwals, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC-21792 Issued in AZ

Practice address

3355 N Wild Daisy PL
Tucson, AZ 85750-3139

Phone

(505) 336-0088

NPI assigned

Jun 27, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 28, 2026 through Jan 28, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1831540210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 N WILD DAISY PL",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857503139",
            "telephone_number": "505-336-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 N WILD DAISY PL",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857503139",
            "telephone_number": "505-336-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTWALS",
        "first_name": "JACOB",
        "middle_name": "KULP",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-27",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPC.0016856",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "CCMH0206221",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC-21792",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "TPMC1646",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabel Maria Gossler, MD
• Kenneth B Gossler, M.D.
• Osvaldo Gotay Ruiz, LCSW
• Jamie Gothup
• Gary P Gottlieb, M.D.
• Jordan Gotwalt-Bish, MD
• Judy London Gould, SLP
• Katherine Gould, R.N.
• Stacey Lee Goulet
• Rebecca Lauren Goulson, MD

• Mental Health Counselor in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.