Healthcare Provider Details

I. General information

NPI: 1457013740
Provider Name (Legal Business Name): JORDAN WARTA LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2021
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8400 RED BUG LAKE RD STE 2080
OVIEDO FL
32765-6835
US

IV. Provider business mailing address

8400 RED BUG LAKE RD STE 2080
OVIEDO FL
32765-6835
US

V. Phone/Fax

Practice location:
  • Phone: 833-769-3524
  • Fax: 321-348-9984
Mailing address:
  • Phone: 833-769-3524
  • Fax: 321-348-9984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH19972
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: