Healthcare Provider Details

I. General information

NPI: 1003780917
Provider Name (Legal Business Name): JORDAN SELMAN WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2025
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2639 WOOSTER RD
ROCKY RIVER OH
44116-2911
US

IV. Provider business mailing address

14308 SUPERIOR RD APT 3
CLEVELAND HEIGHTS OH
44118-1774
US

V. Phone/Fax

Practice location:
  • Phone: 216-309-0697
  • Fax:
Mailing address:
  • Phone: 216-309-0697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JORDAN SELMAN
Title or Position: OWNER
Credential: LISW
Phone: 216-659-9025