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General NPI Number Information
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NPI Number | 1053932087
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Entity Type | Individual
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Provider Name | JORDAN BALDWIN
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Gender | Female
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Dates
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Enumeration Date | 04/30/2020
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 680 NORTHLAND BLVD
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City | CINCINNATI
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State | OH
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Zip | 45240-3248
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Country | US
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Telephone | 513-941-4999
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Fax |
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Provider Business Mailing Address
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Address Line | 6460 HARRISON AVE STE 200
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City | CINCINNATI
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State | OH
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Zip | 45247-7821
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Country | US
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Telephone | 513-467-2825
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Fax | 513-694-0168
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CDCA.175396
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCDCIII.162289
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CDCA.172948
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License Number State | OH
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