Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1679023402 Individual Practitioner Female Practitioner

Jan S Kimball , LPCC

Counselor • Mentor, OH

Professional Overview & Biography Verified Profile Summary

Jan Kimball, LPCC is a registered healthcare professional specializing in Counselor in Mentor, OH. Practice services are available at 7232 JUSTIN WAY under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

7232 Justin Way

Mentor, OH 440604881

Telephone 4405788200
Associated Practice Facility / Clinic
🏢 Signature Health Inc. Facility NPI 1184170136

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor in Mentor, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 11.3 Yrs
State Avg: 13.0 Yrs
Regional Practice Density
113 Specialists

Practicing in Mentor, OH (4163 Statewide)

Telehealth Adoption Rate
0.9% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2021-06-29
Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

State License OH E.0008013

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Counselor - Professional

NUCC Taxonomy Code: 101YP2500X

State License OH E0008013

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
0187764 (OH)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Tiffany Jones , MD

Psychiatry & Neurology - Psychiatry

NPI 1003082413

Doctor of Medicine (M.D.)

Ashley Focht

Counselor

NPI 1003329079
Fatimaah Fullilove , LSW, LICDC

Social Worker - Clinical

NPI 1003329228

Licensed Social Worker, LICDC

NPI 1003420076

Licensed Professional Clinical Counselor

NPI 1003420738
Clotilda Raymond

Social Worker

NPI 1003436825

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location June 29, 2021

Registered at 7232 JUSTIN WAY, MENTOR, OH 440604881 (Tel: 4405788200)

📍
Updated Business Mailing Address June 29, 2021

Registered at 7232 JUSTIN WAY, MENTOR, OH 440604881 (Tel: 4405788200)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 29, 2021

Counselor (License #E.0008013 in OH)

NPI Profile Active October 05, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location October 05, 2016

Registered at 38882 MENTOR AVE, C/O SIGNATURE HEALTH, WILLOUGHBY, OH 440947875 (Tel: 4409539999)

📍
Updated Business Mailing Address October 05, 2016

Registered at 38882 MENTOR AVE, C/O SIGNATURE NEALTH, WILLOUGHBY, OH 440947875 (Tel: 4409539999)

👤
Provider Name / Credentials Updated October 05, 2016

Recorded as JAN KIMBALL, LPCC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 05, 2016

Counselor (License #E0008013 in OH)

🟢
Initial NPI Registration & Enumeration October 05, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1679023402
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 05, 2016
Last Update: June 29, 2021
Sole Proprietor: Yes

Mailing Address

7232 Justin Way

Mentor, OH 440604881

Phone: 4405788200

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.