DEREK R. JORDAN NPI 1669911285

NPI Information

  • NPI: 1669911285
  • Provider Name: DEREK R. JORDAN
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Individual
  • Address: 25 WHITNEY DR STE 122
    MILFORD, OH
    ZIP 45150
  • Phone: (513) 941-4999

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NPI Details

Derek R. Jordan is a professional counselor in Milford, OH. Derek R. Jordan NPI is 1669911285. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

25 WHITNEY DR STE 122
MILFORD, OH
ZIP 45150-400
Phone: (513) 941-4999
Fax: (513) 694-0168

The enumeration date for this NPI number is 2/15/2017 and was last updated on 11/14/2024.

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
1101YA0400XCounselorAddiction (Substance Use Disorder)LCDCIII.121091OHIONo
2101YP2500XCounselorProfessionalE.2303715OHIONo
3101YP2500XCounselorProfessionalC.1600018OHIONo
4101YP2500XCounselorProfessionalE.2303715-SUPVOHIOYes
5101YA0400XCounselorAddiction (Substance Use Disorder)LICDC.161401OHIONo
6101YA0400XCounselorAddiction (Substance Use Disorder)LCDCII.121091OHIONo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10218756MEDICAIDOHIO

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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