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NPI Code Detail

MEDICARE: MRS. JORDAN RENAE MCDOWELL MA, LPC-CANDIDATE

MEDICARE: MRS. JORDAN RENAE MCDOWELL MA, LPC-CANDIDATE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselorOK

General Provider Information

NPI Number : 1417564543
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JORDAN RENAE MCDOWELL MA, LPC-CANDIDATE
Provider Business Mailing Address
First Line : 425 S FRETZ AVE STE C
Second Line :
City : EDMOND
State : OK
Zip : 73003-5568
Country : US
Telephone Number : 405-726-9808
Fax Number : 405-726-9809
Provider Business Practice Location Address
First Line : 425 S FRETZ AVE STE C
Second Line :
City : EDMOND
State : OK
Zip : 73003-5568
Country : US
Telephone Number : 405-726-9808
Fax Number : 405-726-9809
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2020
Last Update Date : 09/23/2020

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