Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jordan Community Residential

Organization Mental Health Counselor · NPI 1467098822

Jordan Community Residential is a Mental Health Counselor in Willoughby, Ohio. Registered with an NPI since 2019.

In the registry since
2019

Practice location Address checks out

30841 Euclid Ave Ste 103
Willoughby, OH 44094-3100
Phone: (216) 441-2496
Fax: (216) 634-9611
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X

Record details

NPI number1467098822
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tenisha Gant — Chief Executive Officer · (216) 441-2496
NPI enumeratedNovember 20, 2019
Last updated in NPPESApril 26, 2024
Certification dateApril 24, 2024
Mailing address30841 Euclid Ave Ste 103, Willoughby, OH 44094-3100

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