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NPI Code Detail

MEDICARE: JEFFREY C OLEN

MEDICARE: JEFFREY C OLEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorLCDC.131154.3OH

General Provider Information

NPI Number : 1578019857
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY C OLEN
Provider Business Mailing Address
First Line : 6140 S BROADWAY
Second Line :
City : LORAIN
State : OH
Zip : 44053-3821
Country : US
Telephone Number : 440-233-7232
Fax Number : 440-233-9070
Provider Business Practice Location Address
First Line : 6140 S BROADWAY
Second Line :
City : LORAIN
State : OH
Zip : 44053-3821
Country : US
Telephone Number : 440-233-7232
Fax Number : 440-233-9070
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2016
Last Update Date : 01/14/2026

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Directions to “ JEFFREY C OLEN ” Practice Location

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