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Tyler Jackson , LSW

Counselor β€’ Columbus, OH

Active NPI 1770252397 Individual Practitioner Male Practitioner
Practice location in NPPES

815 W Broad St Ste 200
Columbus, OH 432221478

Call 6147170822 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

815 W Broad St Ste 200

Columbus, OH 432221478

Telephone 6147170822
Organization at the Same NPPES Address or Phone
Basecamp Recovery Llc Facility NPI 1730702333

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2021

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Columbus and Ohio

328 active clinicians are listed under Counselor with a practice address in Columbus, OH (4,098 in Ohio).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Columbus

0.9% of these 328 clinicians have the CMS telehealth indicator.

2.4% of these 328 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2022-06-15
Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

License # reported to NPPES OH 2101853

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: State Medical Board of Ohio.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

3 listed
Dr. Robert Graessle , DO

Psychiatry & Neurology - Addiction Medicine

NPI 1629274139

Doctor of Osteopathic Medicine (D.O.)

Ruth Lyons , LISW - S

Social Worker - Clinical

NPI 1508946559

LISWS

Benjamin Sheppard , PMHNP-BC

Nurse Practitioner - Psychiatric/Mental Health

NPI 1699414722

Psychiatric-Mental Health Nurse Practitioner (Board Certified)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
πŸ‘€
Provider Name / Credentials Updated June 15, 2022

Recorded as TYLER JACKSON, LSW

βœ…
NPI Profile Active September 08, 2021

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) September 08, 2021

Registered at 815 W BROAD ST STE 200, COLUMBUS, OH 432221478 (Tel: 6147170822)

πŸ“
Business Mailing Address (Initial Record) September 08, 2021

Registered at 815 W BROAD ST STE 200, COLUMBUS, OH 432221478 (Tel: 6147170822)

πŸ‘€
Provider Name / Credentials (Initial Record) September 08, 2021

Recorded as TYLER JACKSON, SWT

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 08, 2021

Counselor (license number reported to NPPES: OH 2101853)

🟒
Initial NPI Registration & Enumeration September 08, 2021

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1770252397
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 08, 2021
Last Update: June 15, 2022
Sole Proprietor: Yes

Mailing Address

815 W Broad St Ste 200

Columbus, OH 432221478

Phone: 6147170822

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.