Provider Demographics
NPI:1942630876
Name:GEMZER, JORDAN BLAIR (MS, PCC)
Entity Type:Individual
Prefix:MS
First Name:JORDAN
Middle Name:BLAIR
Last Name:GEMZER
Suffix:
Gender:F
Credentials:MS, PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 OFFICENTER PL
Mailing Address - Street 2:SUITE 290
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-5317
Mailing Address - Country:US
Mailing Address - Phone:888-336-1772
Mailing Address - Fax:614-453-8801
Practice Address - Street 1:540 OFFICENTER PL
Practice Address - Street 2:SUITE 290
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-5317
Practice Address - Country:US
Practice Address - Phone:888-336-1772
Practice Address - Fax:614-453-8801
Is Sole Proprietor?:No
Enumeration Date:2013-11-13
Last Update Date:2014-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE. 1000355101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional