Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacob D Crosby, LISW, LICDC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1508306382

Jacob D Crosby, LISW, LICDC is a Clinical Social Worker in Lorain, Ohio. Qualified in 2015, 11 years ago. Licensed in Ohio.

Years since qualifying
11
Licensed in
OH
In the registry since
2017
Specialties on file
2
What do these letters mean?
LISW — Licensed Independent Social Worker
A social worker licensed to practise independently.

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Practice location Address checks out

6140 S Broadway
Lorain, OH 44053-3821
Phone: (440) 233-7232
Fax: (440) 233-9070
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence I.2304680-SUPV (OH)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence LICDC.162822 (OH)

Record details

NPI number1508306382
Entity typeIndividual (Type 1)
GenderMale
Credentials LISW , LICDC
Sole proprietorNo
NPI enumeratedFebruary 28, 2017
Last updated in NPPESMay 28, 2025
Certification dateMay 28, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Accepts Medicare assignment Not indicated

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