Healthcare Provider Details

I. General information

NPI: 1780345520
Provider Name (Legal Business Name): JORDAN J PAKIS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2022
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 MCCAIN PARK DR STE 102
NORTH LITTLE ROCK AR
72116-7849
US

IV. Provider business mailing address

20400 COLONEL GLENN RD
LITTLE ROCK AR
72210-5323
US

V. Phone/Fax

Practice location:
  • Phone: 501-771-8261
  • Fax: 501-771-8263
Mailing address:
  • Phone: 501-821-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberP2505001
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberA2310001
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: