Healthcare Provider Details

I. General information

NPI: 1750009312
Provider Name (Legal Business Name): JORDAN SELMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2022
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13940 CEDAR RD # 206
UNIVERSITY HTS OH
44118-3204
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 440-591-4366
  • Fax:
Mailing address:
  • Phone: 216-659-9025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberI.2506406
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: