Healthcare Provider Details

I. General information

NPI: 1891566253
Provider Name (Legal Business Name): NJORDANCOUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2024
Last Update Date: 02/16/2024
Certification Date: 02/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6615 FLORA AVE
KANSAS CITY MO
64131-1409
US

IV. Provider business mailing address

6615 FLORA AVE
KANSAS CITY MO
64131-1409
US

V. Phone/Fax

Practice location:
  • Phone: 816-514-1087
  • Fax:
Mailing address:
  • Phone: 816-514-1087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NICHOLAS JORDAN
Title or Position: THERAPIST/OWNER
Credential: MA, LPC
Phone: 816-514-1087