Individual provider Active NPI

Jason D Jordan, LSW, LICDC-GAMB

  • Social Worker
  • Elyria, OH
National Provider Identifier
1801428529
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S.2308821 Issued in OH
Practice address
750 Abbe Rd S
Elyria, OH 44035-7246
Phone
(440) 323-5121
Fax
(440) 323-5134
NPI assigned
Feb 11, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.2308821 OH Primary
Case Manager/Care Coordinator 171M00000X OH
Community Health Worker 172V00000X OH
Addiction (Substance Use Disorder) Counselor 101YA0400X LICDC.162933 OH

Addresses

Primary practice location

750 Abbe Rd S
Elyria, OH 44035-7246

Mailing address

216 W 30TH St
Lorain, OH 44055-1173
Phone (440) 234-2006

Other practice location 1

285 S Professor St
Oberlin, OH 44074-1581
Phone (440) 662-3639

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
CDCA172678OHMDAddiction (Substance Use Disorder) Counselor
S.2308821OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Prosper Behavioral Health Services LLC Addiction (Substance Use Disorder) Current Accepting new patients
Janatus Transport PastSince Dec 18, 2022 Accepting new patients

Organizations & group practices 2

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": "1581379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1801428529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 W 30TH ST",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440551173",
            "telephone_number": "440-234-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 ABBE RD S",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440357246",
            "telephone_number": "440-323-5121",
            "fax_number": "440-323-5134"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "285 S Professor St",
            "address_purpose": "LOCATION",
            "city": "Oberlin",
            "state": "OH",
            "postal_code": "440741581",
            "country_code": "US",
            "telephone_number": "440-662-3639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "JASON",
        "middle_name": "D",
        "credential": "LSW, LICDC-GAMB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-11",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.2308821",
            "primary": true
        },
        {
            "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": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.162933",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elyria, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; 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.