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General NPI Number Information
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NPI Number | 1770488967
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Entity Type | Organization
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Legal Business Name | JORDAN CONKLIN, LMFT, PLLC
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Dates
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Enumeration Date | 10/09/2026
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Last Update Date | 10/09/2026
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Provider Practice Location Address
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Address Line | 2512 INDEPENDENCE BLVD STE 100-54
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City | WILMINGTON
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State | NC
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Zip | 28412-2571
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Country | US
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Telephone | 910-777-7597
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Fax |
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Provider Business Mailing Address
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Address Line | 609 PINER RD STE A 579
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City | WILMINGTON
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State | NC
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Zip | 28409-4201
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Country | US
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Telephone | 910-777-7597
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JORDAN CONKLIN
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Credential | LMFT
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Telephone | 910-777-7597
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State | NULL
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