Individual provider Active NPI

Rebecca Jordan, LPC

  • Mental Health Counselor
  • Cuyahoga Falls, OH
National Provider Identifier
1154930733
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C.2103411 Issued in OH
Practice address
1865 Bailey Rd
Cuyahoga Falls, OH 44221-5211
Phone
(330) 928-2042
NPI assigned
Jul 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Mental Health Counselor 101YM0800X C.2103411 OH Primary

Addresses

Primary practice location

1865 Bailey Rd
Cuyahoga Falls, OH 44221-5211

Mailing address

1865 Bailey Rd
Cuyahoga Falls, OH 44221-5211
Phone (330) 928-2042

Other practice location 1

87 N Canton Rd
Akron, OH 44305-3838
Phone (330) 794-4254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C.2103411OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Akron Children'S Hospital Current Accepting new patients
Child Guidance & Family Solutions PastSince Aug 1, 2020 Accepting new patients
Child Guidance & Family Solutions PastSince Aug 1, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rjordan122026@direct.chmca.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1154930733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1865 BAILEY RD",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442215211",
            "telephone_number": "330-928-2042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1865 BAILEY RD",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442215211",
            "telephone_number": "330-928-2042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "87 N Canton Rd",
            "address_purpose": "LOCATION",
            "city": "Akron",
            "state": "OH",
            "postal_code": "443053838",
            "country_code": "US",
            "telephone_number": "330-794-4254",
            "fax_number": "330-794-4262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "REBECCA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-29",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.2103411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cuyahoga Falls, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.