Healthcare Provider Details

I. General information

NPI: 1205349032
Provider Name (Legal Business Name): LINDSEY MARIE JORDAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2017
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 CLAREMONT ST STE C
KALISPELL MT
59901-3500
US

IV. Provider business mailing address

197 TRUMBLE LANE
COLUMBIA FALLS MT
59912
US

V. Phone/Fax

Practice location:
  • Phone: 406-758-5155
  • Fax: 406-758-5166
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1000
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number1000
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: