# JACOB KULP GOTWALS

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1831540210
- **Gender:** Man
- **Credential:** MA

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | CCMH0206221 | NM | — |
| 101YM0800X | Mental Health Counselor | LPC-21792 | AZ | Yes |
| 101YM0800X | Mental Health Counselor | LPC.0016856 | CO | — |
| 101YM0800X | Mental Health Counselor | TPMC1646 | FL | — |
| 101YP2500X | Professional Counselor | CCMH0206221 | NM | — |
| 101YP2500X | Professional Counselor | LPC.0016856 | CO | — |

## Other

- **Enumeration date:** 06/27/2016
- **Last updated:** 01/28/2026