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General NPI Number Information
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NPI Number | 1043196496
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Entity Type | Organization
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Legal Business Name | JORDAN PSYCHOLOGICAL SERVICES, LLC
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Dates
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Enumeration Date | 08/12/2025
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 5707 CALVERTON ST STE 1C
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City | CATONSVILLE
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State | MD
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Zip | 21228-1780
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Country | US
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Telephone | 410-747-7991
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Fax | 410-747-5188
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Provider Business Mailing Address
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Address Line | 5707 CALVERTON ST STE 1C
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City | CATONSVILLE
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State | MD
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Zip | 21228-1780
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Country | US
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Telephone | 410-747-7991
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Fax | 410-747-5188
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | LISA JORDAN
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Credential | PH.D.
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Telephone | 410-747-7991
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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