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NPI Code Detail

MEDICARE: JORDAN COUNSELING AND ASSOCIATES

MEDICARE: JORDAN COUNSELING AND ASSOCIATES
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
1101YM0800XMental Health CounselorE0002649OH
2104100000XSocial WorkerI9562OH

General Provider Information

NPI Number : 1689934853
Entity Type Code : Organization
Provider Name (Legal Business Name) : JORDAN COUNSELING AND ASSOCIATES
Provider Business Mailing Address
First Line : 2295 W MARKET ST
Second Line : SUITE B
City : AKRON
State : OH
Zip : 44313-6944
Country : US
Telephone Number : 330-835-9550
Fax Number : 330-835-9552
Provider Business Practice Location Address
First Line : 2295 W MARKET ST
Second Line : SUITE B
City : AKRON
State : OH
Zip : 44313-6944
Country : US
Telephone Number : 330-835-9550
Fax Number : 330-835-9552
Authorized Official
Title or Position : OWNER
Name : KRISTINE M JORDAN
Credential : LISWS
Telephone Number : 216-906-9333
Provider Enumeration Date : 05/22/2012
Last Update Date : 05/22/2012

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Directions to “JORDAN COUNSELING AND ASSOCIATES ” Practice Location

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