JORDON M DISTAD LPCC NPI 1346965506

NPI Information

  • NPI: 1346965506
  • Provider Name: JORDON M DISTAD, LPCC
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 8224 MENTOR AVE STE 208
    MENTOR, OH
    ZIP 44060
  • Phone: (440) 392-2222

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NPI Details

Jordon M Distad, LPCC is a professional counselor in Mentor, OH. Jordon M Distad, LPCC NPI is 1346965506. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

8224 MENTOR AVE STE 208
MENTOR, OH
ZIP 44060-743
Phone: (440) 392-2222
Fax: (440) 565-2389

The NPI 1346965506 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 10/10/2022 and was last updated on 10/10/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YP2500XCounselorProfessionalE2203129OHIOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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