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JACOB R KELLER LPCC
NPI 1629340856
Counselor - Professional in Eaton, OH

Active since February 03, 2012PECOS Enrolled
411 W MAIN ST, EATON, OH 45320(937) 475-9124 Get Directions Write a Review

NPPES record last updated: September 12, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jacob R Keller Lpcc NPPES

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

JACOB R KELLER LPCC (NPI 1629340856) is an individual professional provider in Eaton, Ohio, licensed in Ohio (E1000620) and active in the NPI registry since February 2012. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629340856
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameJACOB R KELLERCredential: LPCC
Location Address411 W MAIN STEaton, OH 45320-1624
Mailing Address411 W Main StEaton, OH 45320-1624 · (937) 475-9124
Phone(937) 475-9124
Sole ProprietorYes
Enumeration DateFebruary 3, 2012
Last NPPES UpdateSeptember 12, 2023
NPPES CertifiedSeptember 12, 2023
✔ NPI 1629340856 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in OH · E1000620
411 W MAIN ST, Eaton, OH 45320
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacob R Keller Lpcc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jacob Keller reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Counseling Source Inc
36 mi
Mental Health
10921 REED HARTMAN HWY, SUITE 133
Blue Ash, OH 45242
  • Reassigned Medicare billing, Ohio enrollment
  • 72 clinicians in this Medicare group
NPI 1639438518 (513) 984-9838

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 Keller's NPI number?

The NPI number for Jacob Keller is 1629340856. It was assigned to this individual provider in the NPPES registry on February 3, 2012.

Where is Jacob Keller located?

Jacob Keller practices at 411 W Main St, Eaton, OH 45320. The listed phone number is (937) 475-9124.

What is Jacob Keller's specialty?

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

Is Jacob Keller enrolled in Medicare?

Yes. Jacob Keller is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jacob Keller's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacob Keller reassigns Medicare benefits to Counseling Source Inc (Blue Ash, OH). The 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 Jacob Keller's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jacob Keller accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and MedMutual list Jacob Keller 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 Keller was last updated on September 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.