Jordan Elizabeth Oberholtzer

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

312 3Rd St
Elyria, OH 44035-5618

Phone

(440) 323-5707

NPI assigned

Mar 15, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 15, 2026 through Jan 15, 2028

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/pathwayscounselingcenter/r4/

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.

• Pathways Counseling and Growth Center

  • Community/Behavioral Health Agency
  • Elyria, OH
  • NPI 1760450837
  NPD
• Pathways Counseling and Growth Center

  • Community/Behavioral Health Agency
  • Grafton, OH
  • NPI 1801104799
  NPD (past)

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

{
    "created_epoch": "1647302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1679221949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "686 PERRY ST",
            "city": "VERMILION",
            "state": "OH",
            "postal_code": "440891162",
            "telephone_number": "440-522-9381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 3RD ST",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440355618",
            "telephone_number": "440-323-5707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBERHOLTZER",
        "first_name": "JORDAN",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-15",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northeast Ohio Optometric Services and Contact Lens Supply
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• Olivia Kordrene O'Dell
• Kristine O'Neal
• Charles David O'Shaughnessy, M.D.
• Janet Odell, OTRL
• Bonaventure Chukwuemeke Ogbechie, MD
• Ohio CVS Stores LLC
• Ohio CVS Stores LLC
• Ohio Spine and Body Inc

• Mental Health Counselor in Elyria, OH
• Providers in Elyria, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.