Jordan Christian Puccinelli, LPCC M.ED

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

E.2505015 Issued in OH

Practice address

202 E Bagley Rd
Berea, OH 44017-2058

Phone

(440) 260-8300

NPI assigned

Apr 23, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Cornerstone Pathways, LLC

  dba New Care Behavioral Health

  • Counselor
  • Wellington, OH
  • NPI 1023779303

  Mental Health

  Medicare reassignment NPD
• Ohioguidestone

  • Community/Behavioral Health Agency
  • Berea, OH
  • NPI 1295096758
  NPD (past)

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

{
    "created_epoch": "1619136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756512000000",
    "number": "1730761370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6255 W RIVER RD S",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440355433",
            "telephone_number": "440-420-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E BAGLEY RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440172058",
            "telephone_number": "440-260-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCCINELLI",
        "first_name": "JORDAN",
        "middle_name": "CHRISTIAN",
        "credential": "LPCC M.ED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-23",
        "last_updated": "2025-08-30",
        "certification_date": "2025-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.2505015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alfred Preston, QMHS, CMS
• Primcare Transportation Services
• Procare Vision Center
• Ciara Pruitt
• Carol L Pryor
• Crystal Marie Pugh, LSW
• Giuliana Pugliese, QMHS BA
• Samantha Radel
• Jessie Lee Radtka
• Brandy Elizabeth Rahm

• Mental Health Counselor in Berea, OH
• Providers in Berea, 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 Aug 30, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.