Active NPI
Craig Michael Jordan, CDCA
- Addiction (Substance Use Disorder) Counselor
- Rock Creek, OH
National Provider Identifier
1992260038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 140478
- Practice address
- 2863 State Route 45 N
Rock Creek, OH 44084-9352 - Phone
- (440) 563-3400
- NPI assigned
- Feb 3, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 140478 | OH | Primary |
Addresses
Primary practice location
2863 State Route 45 N
Rock Creek, OH 44084-9352
Mailing address
110 Orchard Ave
Niles, OH 44446-5242
Phone (440) 969-8088
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 |
|---|---|---|---|
| 140478 | 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": "1549152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549152000000",
"number": "1992260038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 ORCHARD AVE",
"city": "NILES",
"state": "OH",
"postal_code": "444465242",
"telephone_number": "440-969-8088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2863 STATE ROUTE 45 N",
"city": "ROCK CREEK",
"state": "OH",
"postal_code": "440849352",
"telephone_number": "440-563-3400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "CRAIG",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "CDCA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-02-03",
"last_updated": "2019-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "140478",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rock Creek, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.