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

Shane Jacobs

Individual provider Professional Counselor · NPI 1770300634

Shane Jacobs is a Mental Health Counselor in Columbus, Ohio. Qualified in 2025, 1 year ago. Practices as a sole proprietor. Licensed in Ohio.

Years since qualifying
1
Licensed in
OH
In the registry since
2024
Specialties on file
5
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Practice location Address checks out

245 N Grant Ave
Columbus, OH 43215-2641
Phone: (614) 224-6617
Fax: (855) 208-4527
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence C.2507289 (OH)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X
School Counselor Taxonomy 101YS0200X
Counselor Taxonomy 101Y00000X
Mental Health Counselor Taxonomy 101YM0800X

Record details

NPI number1770300634
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedSeptember 23, 2024
Last updated in NPPESMarch 25, 2026
Certification dateMarch 25, 2026
Mailing address245 N Grant Ave, Columbus, OH 43215-2641

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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