Healthcare Provider Details

I. General information

NPI: 1174344428
Provider Name (Legal Business Name): JORDAN DAYLE CRAIG MS, LPC, NCC, QMHP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2024
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5021 S BUR OAK PL
SIOUX FALLS SD
57108-2228
US

IV. Provider business mailing address

5021 S BUR OAK PL
SIOUX FALLS SD
57108-2228
US

V. Phone/Fax

Practice location:
  • Phone: 605-937-6654
  • Fax:
Mailing address:
  • Phone: 605-937-6654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCMH30943
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC20870
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: