Healthcare Provider Details

I. General information

NPI: 1033661426
Provider Name (Legal Business Name): JORDAN K DRISKELL M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JORDAN YARBROUGH

II. Dates (important events)

Enumeration Date: 11/01/2016
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 N MICHIGAN AVE
CHICAGO IL
60601-7757
US

IV. Provider business mailing address

211 N BRAGG AVE
LOOKOUT MOUNTAIN TN
37350-1203
US

V. Phone/Fax

Practice location:
  • Phone: 312-766-6780
  • Fax:
Mailing address:
  • Phone: 423-355-8786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2444
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateKS
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number108635
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: