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MR. JACOB CARLISLE HOSTETTER CLINICAL COUNSELOR
NPI 1386187276
Counselor - Mental Health in Dallas, OR

Active since November 23, 2016Opted out of Medicare · through Dec 17, 2027
182 SW ACADEMY ST, DALLAS, OR 97338(503) 623-9289 Get Directions Write a Review

NPPES record last updated: September 25, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 25, 2019, Mar 17, 2018, Jun 13, 2017 and 1 more (4 updates tracked since 2016).

About Mr. Jacob Carlisle Hostetter Clinical Counselor NPPES

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

MR. JACOB CARLISLE HOSTETTER CLINICAL COUNSELOR (NPI 1386187276) is an individual mental health provider in Dallas, Oregon and active in the NPI registry since November 2016. He has opted out of Medicare through December 17, 2027 and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1386187276
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameMR. JACOB CARLISLE HOSTETTERCredential: CLINICAL COUNSELOR
Location Address182 SW ACADEMY STDallas, OR 97338-1996
Mailing Address36 Sw Nye StNewport, OR 97365-3821 · (541) 265-4179 · Fax (541) 265-4112
Phone(503) 623-9289
Sole ProprietorNo
Enumeration DateNovember 23, 2016
Last NPPES UpdateSeptember 25, 20194 updates tracked since enumeration
✔ NPI 1386187276 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X
182 SW ACADEMY ST, Dallas, OR 97338
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Secondary Practice Locations 2

Location 14422 NE Devils Lake Blvd Ste 2Lincoln City, OR 97367-5000 · Phone (541) 265-4196 · Fax (541) 994-1882
Location 251 SW Lee StNewport, OR 97365-3823 · Phone (541) 574-5960 · Fax (541) 265-0601

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, PacificSource Health Plans, Regence BlueCross BlueShield of Oregon.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mr. Jacob Carlisle Hostetter Clinical Counselor has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from December 17, 2025 through December 17, 2027.

Opt-Out Effective DateDecember 17, 2025
Opt-Out In Effect ThroughDecember 17, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JESSICA LYNN DAVIDSON
Case Manager/Care Coordinator
182 SW ACADEMY ST
DALLAS, OR 97338
Polk County (503) 623-9289
ROBERT AUSTIN ZEPEDA
Peer Specialist
182 SW ACADEMY ST
DALLAS, OR 97338
Polk County (503) 962-3928
KIMBERLY DAWN HOWARD QMHA
Counselor
182 SW ACADEMY ST, SUITE 304
DALLAS, OR 97338
Polk County (503) 623-9289
JEDONNE JORSTAD BA
Counselor (Mental Health)
182 SW ACADEMY ST, STE 304
DALLAS, OR 97338
Polk County (503) 623-9289
MELANIE MYERS M.S.
Social Worker
182 SW ACADEMY ST
DALLAS, OR 97338
Polk County (503) 831-5970
ZACHARY BEELER
Counselor (Mental Health)
182 SW ACADEMY ST
DALLAS, OR 97338
Polk County (503) 623-9289
LINNEA BAKER
Peer Specialist
182 SW ACADEMY ST
DALLAS, OR 97338
Polk County (503) 623-9289
SUSAN MARIE KLEIN
Counselor (Addiction (Substance Use Disorder))
182 SW ACADEMY ST, SUITE 304
DALLAS, OR 97338
Polk County (503) 623-9289

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Hostetter's NPI number?

The NPI number for Jacob Hostetter is 1386187276. It was assigned to this individual provider in the NPPES registry on November 23, 2016.

Where is Jacob Hostetter located?

Jacob Hostetter practices at 182 SW Academy St, Dallas, OR 97338. The listed phone number is (503) 623-9289.

What is Jacob Hostetter's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Jacob Hostetter enrolled in Medicare?

No. Jacob Hostetter has opted out of Medicare through December 17, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Jacob Hostetter accept?

Health plans from BridgeSpan Health Company, PacificSource Health Plans and Regence BlueCross BlueShield of Oregon list Jacob Hostetter as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jacob Hostetter was last updated on September 25, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.