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

Mrs. Jacklyn Samuels, LPC

Individual provider Counselor · NPI 1689289100

Mrs. Jacklyn Samuels, LPC is a Mental Health Counselor in Sandusky, Ohio. Qualified in 2017, 9 years ago. Practices with J Kilby Enterprises Inc, an 8-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
9
Licensed in
OH
In the registry since
2020
Specialties on file
2
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

1925 Hayes Ave
Sandusky, OH 44870-4737
Phone: (419) 557-5177
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence C.2103762 (OH)
Counselor Taxonomy 101Y00000X · Licence C.2002650-TRNE (OH)

Record details

NPI number1689289100
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPC
Sole proprietorNo
NPI enumeratedSeptember 11, 2020
Last updated in NPPESOctober 12, 2021
Certification dateOctober 12, 2021
Mailing address675 Bartson Rd, Fremont, OH 43420-9672

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice J Kilby Enterprises Inc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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