# MR. TYLER CHARLES JACOBS-LEWIS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1548005424
- **Gender:** Man
- **Credential:** LMHC, LPCC, CCMHC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | T23093 | IA | — |
| 101YM0800X | Mental Health Counselor | 111725 | IA | Yes |
| 101YM0800X | Mental Health Counselor | 5283 | MN | — |

## Other

- **Enumeration date:** 07/01/2024
- **Last updated:** 11/14/2025