Provider Demographics
NPI:1578959110
Name:MEDDLES, JACOB (LPCC)
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:
Last Name:MEDDLES
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4207 N GENSEN LOOP
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245-7057
Mailing Address - Country:US
Mailing Address - Phone:513-563-6090
Mailing Address - Fax:
Practice Address - Street 1:4030 MOUNT CARMEL TOBASCO RD STE 119
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-3431
Practice Address - Country:US
Practice Address - Phone:513-536-6090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-10
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2002005101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor