Individual provider Active NPI

Jacqueline C Sundol, LPCC

  • Professional Counselor
  • Wooster, OH
National Provider Identifier
1952998379
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.2404147 Issued in OH
Practice address
2000 Noble Dr
Wooster, OH 44691-5353
Phone
(602) 685-6000
NPI assigned
Dec 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC-19460 AZ
Professional Counselor 101YP2500X E.2404147 OH Primary

Addresses

Primary practice location

2000 Noble Dr
Wooster, OH 44691-5353

Mailing address

2000 Noble Dr
Wooster, OH 44691-5353
Phone (330) 264-3232

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20250508001808 TX Practitioner - Mental Health Counselor 8921525387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
University of Texas Medical School at San Antonio, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brave Health Medical Group, PAGroup PAC ID 9537586052, 93 clinicians

Practice addresses (Care Compare)

675 Town Square Blvd
Garland, TX 75040-2992
Phone (305) 579-9538

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC-19460AZMDProfessional Counselor
E.2404147OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Brave Health Medical Group PA CurrentSince May 12, 2025 Accepting new patients
Az Therapy LLC PastSince Jun 11, 2018 Accepting new patients

Locations

1951 NW 7th Ave
Fl 3
Miami, FL 33136
Phone (305) 297-4749

675 Town Square Blvd
Ste 200
Garland, TX 75040
Phone (305) 579-9538

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1609372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1952998379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 NOBLE DR",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446915353",
            "telephone_number": "330-264-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 NOBLE DR",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446915353",
            "telephone_number": "602-685-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDOL",
        "first_name": "JACQUELINE",
        "middle_name": "C",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-31",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-19460",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2404147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

Verify at the official NPI Registry.