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General NPI Number Information
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NPI Number | 1689934853
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Entity Type | Organization
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Legal Business Name | JORDAN COUNSELING AND ASSOCIATES
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Dates
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Enumeration Date | 05/22/2012
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Last Update Date | 05/22/2012
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Provider Practice Location Address
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Address Line | 2295 W MARKET ST SUITE B
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City | AKRON
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State | OH
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Zip | 44313-6944
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Country | US
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Telephone | 330-835-9550
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Fax | 330-835-9552
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Provider Business Mailing Address
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Address Line | 2295 W MARKET ST SUITE B
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City | AKRON
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State | OH
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Zip | 44313-6944
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Country | US
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Telephone | 330-835-9550
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Fax | 330-835-9552
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Authorized Official
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Title or Position | OWNER
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Name | KRISTINE M JORDAN
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Credential | LISWS
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Telephone | 216-906-9333
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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 | E0002649
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | I9562
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License Number State | OH
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