Individual
JACOB MICHAEL SHELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDCA/CPRS
Contact information
Practice address
343 TROY ST, DAYTON, OH 45404-1830
(937) 949-1524
Mailing address
343 TROY ST, DAYTON, OH 45404-1830
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.187249
OH
175T00000X
Peer Specialist
Primary
APS.003608
OH
Other
Enumeration date
03/08/2023
Last updated
10/30/2025
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