Provider Demographics
NPI:1073138954
Name:JORGENSEN, JAMES NIELS (JD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:NIELS
Last Name:JORGENSEN
Suffix:
Gender:M
Credentials:JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2728 EUCLID AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44115-2429
Mailing Address - Country:US
Mailing Address - Phone:216-600-5194
Mailing Address - Fax:
Practice Address - Street 1:2728 EUCLID AVE STE 400
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-2429
Practice Address - Country:US
Practice Address - Phone:216-600-5194
Practice Address - Fax:216-600-5197
Is Sole Proprietor?:No
Enumeration Date:2020-06-16
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator