Active NPI
Gary Allen Jaffe, MA, LPC
- Mental Health Counselor
- Lorain, OH
National Provider Identifier
1629188545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- C3632
- Practice address
- 6140 S Broadway
Lorain, OH 44053-3821 - Phone
- (440) 233-7232
- Fax
- (440) 233-5552
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C3632 | OH | Primary |
Addresses
Primary practice location
6140 S Broadway
Lorain, OH 44053-3821
Mailing address
78 Carr Rd
Hinckley, OH 44233-9715
Phone (330) 278-2116
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C3632 | OH | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629188545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "78 CARR RD",
"city": "HINCKLEY",
"state": "OH",
"postal_code": "442339715",
"telephone_number": "330-278-2116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6140 S BROADWAY",
"city": "LORAIN",
"state": "OH",
"postal_code": "440533821",
"telephone_number": "440-233-7232",
"fax_number": "440-233-5552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAFFE",
"first_name": "GARY",
"middle_name": "ALLEN",
"name_prefix": "Mr.",
"credential": "MA, LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "C3632",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lorain, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.