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NPI 1154916518

NPI 1154916518 : JORDAIN JAMES : ORLANDO, FL

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General NPI Number Information
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    NPI Number           |    1154916518
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    Entity Type          |    Individual 
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    Provider Name        |    JORDAIN JAMES
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/07/2021
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    Last Update Date     |    03/07/2021
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Provider Practice Location Address
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    Address Line         |    518 PEACHTREE RD 
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    City                 |    ORLANDO
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    State                |    FL
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    Zip                  |    32804-6813
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    Country              |    US
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    Telephone            |    407-730-7983
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    480 N ORANGE AVE APT 238 
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    City                 |    ORLANDO
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    State                |    FL
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    Zip                  |    32801-1864
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    Country              |    US
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    Telephone            |    347-835-8879
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    
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    License Number State |    
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