Jacob William Mauck, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

99102099A Issued in IN

Practice address

1205 Applegate LN
Clarksville, IN 47129-9608

Phone

(812) 283-8383

NPI assigned

Mar 2, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Personal Counseling Services IncGroup PAC ID 2264931880, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Personal Counseling Services, Inc.

  • Mental Health Counselor
  • Clarksville, IN
  • NPI 1285793380
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1614643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1952996977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 APPLEGATE LN",
            "city": "CLARKSVILLE",
            "state": "IN",
            "postal_code": "471299608",
            "telephone_number": "812-283-8383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 APPLEGATE LN",
            "city": "CLARKSVILLE",
            "state": "IN",
            "postal_code": "471299608",
            "telephone_number": "812-283-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUCK",
        "first_name": "JACOB",
        "middle_name": "WILLIAM",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-02",
        "last_updated": "2021-03-02",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "99102099A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmauck@pcs-counseling.org",
            "affiliation": "N",
            "endpointDescription": "Professional email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1205 Applegate Ln",
            "city": "Clarksville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "471299608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sydney Martin, RBT
• Robert B Martindale, OD
• Shawna Mathis
• William Anthony Mathis, LCSW, CADC
• Rebecca Mattingly
• Pete Mayfield IV, M.D.
• Tabitha Mayott, LMHC
• Melanie McAlister, OTR/L
• Casondra McCartney
• Traci A McCartney, APN

• Mental Health Counselor in Clarksville, IN
• Providers in Clarksville, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.