Healthcare Provider Details

I. General information

NPI: 1831816537
Provider Name (Legal Business Name): JORDAN NIKOLE KESSLER LMFT, LCAS-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2022
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

524 BRAMLET RD APT D
CHARLOTTE NC
28205-8814
US

IV. Provider business mailing address

524 BRAMLET RD APT D
CHARLOTTE NC
28205-8814
US

V. Phone/Fax

Practice location:
  • Phone: 904-510-8438
  • Fax:
Mailing address:
  • Phone: 904-510-8438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number00623
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCAS-28719
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: