Healthcare Provider Details

I. General information

NPI: 1841110038
Provider Name (Legal Business Name): JORDYN BLOCK LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 HADDON BLVD UNIT 1305
MOUNT LAUREL NJ
08054-0589
US

IV. Provider business mailing address

1000 HADDON BLVD UNIT 1305
MOUNT LAUREL NJ
08054-0589
US

V. Phone/Fax

Practice location:
  • Phone: 215-595-7552
  • Fax:
Mailing address:
  • Phone: 215-595-7552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37PC01292100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: