Jacob Ryan Cerrillo
Counselor, Mental Health in Stroudsburg, PA. Individual provider (NPI-1).
NPI number1821882192
StatusActive
Last updated in NPPESApr 9, 2025
Details
- NPI
- 1821882192
- Entity type
- Individual (NPI-1)
- Name
- Jacob Ryan Cerrillo
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 9, 2025
- Certification date
- Apr 9, 2025
- Last updated
- Apr 9, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Practice location
919 Main St Fl 1Stroudsburg, PA 18360-1603
Phone 570-534-0324
Mailing address
919 Main St Fl 1Stroudsburg, PA 18360-1603
Phone 570-534-0324
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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