Individual
JORDAN CHRISTIAN PUCCINELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCC M.ED
Contact information
Practice address
202 E BAGLEY RD, BEREA, OH 44017-2058
(440) 260-8300
Mailing address
6255 W RIVER RD S, ELYRIA, OH 44035-5433
(440) 420-0033
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
E.2505015
OH
171M00000X
Case Manager/Care Coordinator
—
OH
172V00000X
Community Health Worker
—
OH
Other
Enumeration date
04/23/2021
Last updated
08/30/2025
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