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NPI 1639966278

NPI 1639966278 : JOURDAN FACEN LPC : CHICAGO, IL

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General NPI Number Information
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    NPI Number           |    1639966278
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    Entity Type          |    Individual 
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    Provider Name        |    JOURDAN FACEN LPC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/24/2025
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    Last Update Date     |    04/24/2025
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Provider Practice Location Address
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    Address Line         |    124 N SANGAMON ST 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60607-2202
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    Country              |    US
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    Telephone            |    312-226-7984
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    Fax                  |    312-980-0482
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Provider Business Mailing Address
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    Address Line         |    932 W WASHINGTON BLVD 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60607-2217
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    Country              |    US
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    Telephone            |    312-226-7984
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    Fax                  |    312-980-0482
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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        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    178018496
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    License Number State |    IL
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