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Individual

JEFFREY C OLEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
6140 S BROADWAY, LORAIN, OH 44053-3821
(440) 233-7232
(440) 233-9070
Mailing address
6140 S BROADWAY, LORAIN, OH 44053-3821
(440) 233-7232
(440) 233-9070

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDC.131154.3
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LCDC.131154.3
LCDC.131154.3
OH
Enumeration date
08/28/2016
Last updated
01/14/2026
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