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General NPI Number Information
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NPI Number | 1548905771
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Entity Type | Individual
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Provider Name | JORDAN ELIZABETH SMALL LPC
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Gender | Female
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Dates
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Enumeration Date | 05/02/2022
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 4144 N CENTRAL EXPY STE 850
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City | DALLAS
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State | TX
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Zip | 75204-3226
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Country | US
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Telephone | 512-956-6463
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Fax |
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Provider Business Mailing Address
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Address Line | 6909 CLUB CREEK DR
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City | FORT WORTH
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State | TX
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Zip | 76137-3362
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Country | US
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Telephone |
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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 | 83238
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License Number State | TX
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