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General NPI Number Information
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NPI Number | 1497244636
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Entity Type | Individual
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Provider Name | JORDAN PATE-GARRETT LMHC
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Gender | Female
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Dates
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Enumeration Date | 05/03/2018
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 4781 CAUGHLIN PKWY
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City | RENO
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State | NV
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Zip | 89519-0906
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Country | US
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Telephone | 530-584-9017
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Fax |
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Provider Business Mailing Address
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Address Line | 6928 SW 39TH ST APT A304
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City | DAVIE
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State | FL
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Zip | 33314-2472
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Country | US
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Telephone | 954-543-1848
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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 | IMH19266
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License Number State | FL
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