Healthcare Provider Details

I. General information

NPI: 1932091071
Provider Name (Legal Business Name): JORDAN GARBER PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2025
Last Update Date: 07/15/2025
Certification Date: 07/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9666 OLIVE BLVD STE 370
OLIVETTE MO
63132-3025
US

IV. Provider business mailing address

2518 AUTUMN FIELDS LN
WENTZVILLE MO
63385-3071
US

V. Phone/Fax

Practice location:
  • Phone: 636-357-6276
  • Fax:
Mailing address:
  • Phone: 636-357-6276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2025021208
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2025021208
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: