Healthcare Provider Details

I. General information

NPI: 1588038269
Provider Name (Legal Business Name): JORDAN SCHROCK MA, LPC, CCTP, PMH-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2015
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 E LANCASTER AVE STE 1B
DOWNINGTOWN PA
19335-2719
US

IV. Provider business mailing address

63 MEADOWLAKE DR
DOWNINGTOWN PA
19335-2134
US

V. Phone/Fax

Practice location:
  • Phone: 484-237-1853
  • Fax:
Mailing address:
  • Phone: 570-594-6911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPC010434
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: