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Individual

JASON D JORDAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LSW, LICDC-GAMB

Contact information

Practice address
750 ABBE RD S, ELYRIA, OH 44035-7246
(440) 323-5121
(440) 323-5134
Mailing address
216 WEST 30TH STREET, LORAIN, OH 44055
(440) 234-2006

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA172678
OH
104100000X
Social Worker
Primary
S.2308821
OH
171M00000X
Case Manager/Care Coordinator
OH
172V00000X
Community Health Worker
OH

Other

Enumeration date
02/11/2020
Last updated
04/13/2026
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