Active NPI
Jessica Jordan
- Addiction (Substance Use Disorder) Counselor
- Cleveland, OH
National Provider Identifier
1699456541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CDCA.189539
- Practice address
- 3529 Broadview Rd Unit B
Cleveland, OH 44109-3116 - Phone
- (216) 808-3043
- NPI assigned
- Jul 25, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA.189539 | OH | Primary |
Addresses
Primary practice location
3529 Broadview Rd Unit B
Cleveland, OH 44109-3116
Mailing address
3529 Broadview Rd Unit B
Cleveland, OH 44109-3116
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
| License | State | Type | Specialty |
|---|---|---|---|
| CDCA.189539 | OH | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724198400000",
"number": "1699456541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3529 BROADVIEW RD UNIT B",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441093116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3529 BROADVIEW RD UNIT B",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441093116",
"telephone_number": "216-808-3043"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "JESSICA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-07-25",
"last_updated": "2024-08-21",
"certification_date": "2024-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "CDCA.189539",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.