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NPI Code Detail

MEDICARE: ALEC JORDAN

MEDICARE: ALEC JORDAN
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
1101YA0400XAddiction (Substance Use Disorder) CounselorIN

General Provider Information

NPI Number : 1528915501
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEC JORDAN
Provider Business Mailing Address
First Line : 4801 E COUNTY ROAD 67 LOT 23
Second Line :
City : CHESTERFIELD
State : IN
Zip : 46017-9597
Country : US
Telephone Number : 765-587-3667
Fax Number :
Provider Business Practice Location Address
First Line : 3640 N BRIARWOOD LN
Second Line :
City : MUNCIE
State : IN
Zip : 47304-6375
Country : US
Telephone Number : 765-587-3667
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2026
Last Update Date : 03/11/2026

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Directions to “ ALEC JORDAN ” Practice Location

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