JACOB MICHAEL SHELLEY CDCA/CPRS - NPI 1265132211

Q: What is the provider's specialty?

The provider's specialty is Peer Specialist with taxonomy code 175T00000X.

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About Jacob Michael Shelley Cdca/cprs NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACOB MICHAEL SHELLEY CDCA/CPRS (NPI 1265132211) is an individual peer specialist in Dayton, Ohio, licensed in Ohio (APS.003608) and active in the NPI registry since March 2023.

NPPES Registry Identity

NPI1265132211

Entity TypeIndividualMale

Primary Taxonomy175T00000X

Provider Legal NameJACOB MICHAEL SHELLEYCredential: CDCA/CPRS

Location Address343 TROY STDayton, OH 45404-1830

Mailing Address343 Troy StDayton, OH 45404-1830

Phone(937) 949-1524

Sole ProprietorNo

Enumeration DateMarch 8, 2023

Last NPPES UpdateOctober 30, 2025

NPPES CertifiedOctober 30, 2025

✔ NPI 1265132211 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPeer SpecialistOther Service Providers

Taxonomy Code175T00000X

License✔ Licensed in OH · APS.003608

Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License CDCA.187249 (OH)

343 TROY ST, Dayton, OH 45404

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Frequently Asked Questions

What is Jacob Shelley's NPI number?

The NPI number assigned to this healthcare provider is 1265132211, enumerated as an "individual" on March 08, 2023.

Where is the provider located?

The provider is located at 343 TROY ST DAYTON, OH 45404 and the phone number is (937) 949-1524.

What is the provider's specialty?

Peer Specialist with taxonomy code 175T00000X.