MEDICARE: JORDAN DAYLE CRAIG MS, LPC, NCC, QMHP

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
1	101YM0800X	Mental Health Counselor	LPCMH30943	SD
2	101YP2500X	Professional Counselor	LPC20870	SD

General Provider Information

NPI Number	:	1174344428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORDAN DAYLE CRAIG MS, LPC, NCC, QMHP

Provider Business Mailing Address
First Line	:	5021 S BUR OAK PL
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57108-2228
Country	:	US
Telephone Number	:	605-937-6654
Fax Number	:

Provider Business Practice Location Address
First Line	:	5021 S BUR OAK PL
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57108-2228
Country	:	US
Telephone Number	:	605-937-6654
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2024
Last Update Date	:	05/18/2026

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