Individual ProviderJordan GrodkoSocial WorkerBehavioral Health & Social Service ProvidersPractice Address14389 E Carroll Blvd, University Hts, OH 44118-4601(845) 548-1999PECOS EnrollmentBased on the most recent information from CMS, provider Jordan Grodko is legally eligible to order and refer claims for Part B and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1053860452Provider TypeIndividualFull NameGrodko, JordanCredentialLSWGenderMaleSole ProprietorNoEnumeration Date9/26/2016Last Updated5/26/2025Contact InformationPractice LocationPractice Address14389 E Carroll Blvd, University Hts, OH 44118-4601Phone(845) 548-1999FaxUnlisted FaxMailing LocationMailing Address14389 E Carroll Blvd, University Hts, OH 44118-4601Phone(845) 548-1999FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseI.2203841-SUPVOhio