MEDICARE: JORDAN COUNSELING SERVICES LLC

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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1639013212
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JORDAN COUNSELING SERVICES LLC

Provider Business Mailing Address
First Line	:	20814 AUGUSWOOD LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77073-3186
Country	:	US
Telephone Number	:	832-282-3351
Fax Number	:

Provider Business Practice Location Address
First Line	:	20814 AUGUSWOOD LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77073-3186
Country	:	US
Telephone Number	:	832-282-3351
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	SHELITA JORDAN
Credential	:	LPC
Telephone Number	:	832-282-3351

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	04/15/2026

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