Healthcare Provider Details

I. General information

NPI: 1386315513
Provider Name (Legal Business Name): JAZMYN OLMSTEAD LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2021
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 GRAHAM RD STE B
CUYAHOGA FALLS OH
44221-1344
US

IV. Provider business mailing address

421 GRAHAM RD STE B
CUYAHOGA FALLS OH
44221-1344
US

V. Phone/Fax

Practice location:
  • Phone: 330-510-4900
  • Fax: 330-510-5900
Mailing address:
  • Phone: 330-510-4900
  • Fax: 330-510-5900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2204401
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.2204401
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC.2204401
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: