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NPI Code Detail

MEDICARE: SUSAN M JORDAN M.ED.

MEDICARE: SUSAN M JORDAN M.ED.
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 Counselor3194MA

General Provider Information

NPI Number : 1366599839
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN M JORDAN M.ED.
Provider Business Mailing Address
First Line : 3 APACHE TRL
Second Line :
City : ARLINGTON
State : MA
Zip : 02474-1801
Country : US
Telephone Number : 978-256-1288
Fax Number : 978-256-1288
Provider Business Practice Location Address
First Line : 1 MEETING HOUSE RD
Second Line : SUITE 16
City : CHELMSFORD
State : MA
Zip : 01824-2733
Country : US
Telephone Number : 978-256-1288
Fax Number : 978-256-1288
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2007
Last Update Date : 07/08/2007

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Directions to “ SUSAN M JORDAN M.ED.” Practice Location

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