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JACOB'S WELL COUNSELING CENTER INC
NPI 1609558485
Counselor - Professional in Green Bay, WI

Active since August 02, 2023
3340 LINEVILLE RD, GREEN BAY, WI 54313(920) 562-6236 Get Directions Write a Review

NPPES record last updated: April 22, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jacob's Well Counseling Center Inc NPPES

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

JACOB'S WELL COUNSELING CENTER INC (NPI 1609558485) is a healthcare organization registered as a professional in Green Bay, Wisconsin and active in the NPI registry since August 2023. The organization lists Grace Ghost, Administrator, as its authorized official.

NPPES Registry Identity

NPI1609558485
Entity TypeOrganization
Primary Taxonomy101YP2500X
Legal Business NameJACOB'S WELL COUNSELING CENTER INC
Location Address3340 LINEVILLE RDGreen Bay, WI 54313-7237
Mailing Address3340 Lineville RdGreen Bay, WI 54313-7237
Phone(920) 562-6236
Organization SubpartNo
Authorized OfficialGrace GhostAdministrator · (920) 931-2531
Enumeration DateAugust 2, 2023
Last NPPES UpdateApril 22, 2025
NPPES CertifiedApril 22, 2025
✔ NPI 1609558485 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
3340 LINEVILLE RD, Green Bay, WI 54313
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), Dean Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacob's Well Counseling Center Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Jacob's Well Counseling Center Inc, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Erin Luttschwager, MA, LPC, NCC
Mental Health Counselor
NPI 1861122665
3340 LINEVILLE RD
Green Bay, WI 54313
(920) 217-8558
✔ PECOSSame address
Bruce Robertson, PHD
Clinical Psychologist
NPI 1396770434
2631 PACKERLAND DR SUITE 104-C
Green Bay, WI 54313
(920) 965-7701
✔ PECOS6.9 mi
Gretchen Dominowski, LPC-IT, SAC-IT
Mental Health Counselor
NPI 1598381659
1810 APPLETON RD
Menasha, WI 54952
(920) 739-4226
✔ PECOS29 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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's Well Counseling Center Inc's NPI number?

The NPI number for Jacob's Well Counseling Center Inc is 1609558485. It was assigned to this organization in the NPPES registry on August 2, 2023.

Where is Jacob's Well Counseling Center Inc located?

Jacob's Well Counseling Center Inc is located at 3340 Lineville Rd, Green Bay, WI 54313. The listed phone number is (920) 562-6236.

What is Jacob's Well Counseling Center Inc's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Jacob's Well Counseling Center Inc enrolled in Medicare?

Yes. Jacob's Well Counseling Center Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Jacob's Well Counseling Center Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Jacob's Well Counseling Center Inc, in Clinical Psychologist and Mental Health Counselor. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Jacob's Well Counseling Center Inc accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare) and Dean Health Plan list Jacob's Well Counseling Center Inc 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's Well Counseling Center Inc was last updated on April 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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.