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General NPI Number Information
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NPI Number | 1962228494
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Entity Type | Individual
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Provider Name | JORDAN MIKESELL LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/30/2024
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 5445 LEGACY DR STE 270
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City | PLANO
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State | TX
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Zip | 75024-3363
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Country | US
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Telephone | 972-349-0030
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Fax |
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Provider Business Mailing Address
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Address Line | 4101 S CUSTER RD APT 1118
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City | MCKINNEY
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State | TX
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Zip | 75070-6261
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 115339
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 259858
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License Number State | KY
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