Jordon M Distad, LPCC | |
8224 Mentor Ave Ste 208, Mentor, OH 44060-5743 | |
(440) 392-2222 | |
(440) 565-2389 |
Full Name | Jordon M Distad |
---|---|
Gender | Female |
Speciality | Counselor - Professional |
Location | 8224 Mentor Ave Ste 208, Mentor, Ohio |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1346965506 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | E2203129 (Ohio) | Primary |
Entity Name | Aurora Counseling And Consulting Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1568090934 PECOS PAC ID: 0042621062 Enrollment ID: O20201124000855 |
Mailing Address | Practice Location Address |
---|---|
Jordon M Distad, LPCC 8224 Mentor Ave Ste 208, Mentor, OH 44060-5743 Ph: (440) 392-2222 | Jordon M Distad, LPCC 8224 Mentor Ave Ste 208, Mentor, OH 44060-5743 Ph: (440) 392-2222 |
Ashley Nichole Focht, Counselor Medicare: Not Enrolled in Medicare Practice Location: 7232 Justin Way, Mentor, OH 44060 Phone: 440-578-8200 | |
Mrs. Fatimaah D Fullilove, LSW, LICDC Counselor Medicare: Medicare Enrolled Practice Location: 7232 Justin Way, Mentor, OH 44060 Phone: 440-578-8200 | |
Theresa Gill, LPCC Counselor Medicare: Medicare Enrolled Practice Location: 7232 Justin Way, Mentor, OH 44060 Phone: 440-578-8200 | |
Ms. Loretta M. George, M.ED., P.C.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 7244 Hopkins Rd, Mentor, OH 44060 Phone: 440-773-0563 | |
Merav K. Auzenne, MA PC Counselor Medicare: Not Enrolled in Medicare Practice Location: 8445 Munson Rd, Mentor, OH 44060 Phone: 440-255-1700 Fax: 440-205-2417 | |
Kimberlee Bizup, LPCC-S Counselor Medicare: Not Enrolled in Medicare Practice Location: 7232 Justin Way, Mentor, OH 44060 Phone: 440-578-8200 | |
Ivy Novosel, Counselor Medicare: Not Enrolled in Medicare Practice Location: 7232 Justin Way, Mentor, OH 44060 Phone: 440-578-8200 |