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JORDAN COMMUNITY RESIDENTIAL
NPI 1467098822
Counselor - Mental Health in Willoughby, OH

Active since November 20, 2019
30841 EUCLID AVE STE 103, WILLOUGHBY, OH 44094(216) 441-2496(216) 634-9611 Get Directions Write a Review

NPPES record last updated: April 26, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 26, 2024, Nov 20, 2019 (2 updates tracked since 2019).

About Jordan Community Residential NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JORDAN COMMUNITY RESIDENTIAL (NPI 1467098822) is a healthcare organization registered as a mental health in Willoughby, Ohio and active in the NPI registry since November 2019. The organization lists Tenisha Gant, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1467098822
Entity TypeOrganization
Primary Taxonomy101YM0800X
Legal Business NameJORDAN COMMUNITY RESIDENTIAL
Location Address30841 EUCLID AVE STE 103Willoughby, OH 44094-3100
Mailing Address30841 Euclid Ave Ste 103Willoughby, OH 44094-3100 · (216) 441-2496 · Fax (216) 634-9611
Phone(216) 441-2496
Fax(216) 634-9611
Organization SubpartNo
Authorized OfficialTenisha GantChief Executive Officer · (216) 441-2496
Enumeration DateNovember 20, 2019
Last NPPES UpdateApril 26, 20242 updates tracked since enumeration
NPPES CertifiedApril 24, 2024
✔ NPI 1467098822 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
30841 EUCLID AVE STE 103, Willoughby, OH 44094
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Molina Healthcare.Insurance ›

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOCELYN GARDNER SWT
Counselor
30841 EUCLID AVE STE 103
WILLOUGHBY, OH 44094
Lake County (216) 441-2496
JORDAN COMMUNITY RESIDENTIAL CENTER
Psychologist (Addiction (Substance Use Disorder))
30841 EUCLID AVE STE 103
WILLOUGHBY, OH 44094
Lake County (216) 441-2496
JENNIFER LOPEZ CDCA
Counselor (Addiction (Substance Use Disorder))
30841 EUCLID AVE STE 103
WILLOUGHBY, OH 44094
Lake County (216) 441-2496
VASCHEZ C WESTMORELAND CDCA
Counselor (Addiction (Substance Use Disorder))
30841 EUCLID AVE STE 103
WILLOUGHBY, OH 44094
Lake County (216) 441-2496
MS. JOYE E TOOMBS LSW
Social Worker
30841 EUCLID AVE STE 103
WILLOUGHBY, OH 44094
Lake County (216) 441-2496
ALICIA DEXTER CDCA
Counselor (Addiction (Substance Use Disorder))
30841 EUCLID AVE STE 103
WILLOUGHBY, OH 44094
Lake County (216) 441-2496

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jordan Community Residential's NPI number?

The NPI number for Jordan Community Residential is 1467098822. It was assigned to this organization in the NPPES registry on November 20, 2019.

Where is Jordan Community Residential located?

Jordan Community Residential is located at 30841 Euclid Ave Ste 103, Willoughby, OH 44094. The listed phone number is (216) 441-2496.

What is Jordan Community Residential's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

What insurance does Jordan Community Residential accept?

Health plans from Anthem Blue Cross and Blue Shield and Molina Healthcare list Jordan Community Residential as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jordan Community Residential was last updated on April 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.