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NPI Code Detail

MEDICARE: JORDAN FIGHTER

MEDICARE:   JORDAN  FIGHTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor6451023338MI

General Provider Information

NPI Number : 1154859114
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN FIGHTER
Provider Business Mailing Address
First Line : 3890 CHARLEVOIX RD STE 306
Second Line :
City : PETOSKEY
State : MI
Zip : 49770-8423
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3890 CHARLEVOIX RD STE 306
Second Line :
City : PETOSKEY
State : MI
Zip : 49770-8423
Country : US
Telephone Number : 231-412-0660
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2017
Last Update Date : 10/25/2025

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Directions to “ JORDAN FIGHTER ” Practice Location

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