MEDICARE: JORDAN DEMARIS KLAFFER MA, PLPC

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	026026829	MO

General Provider Information

NPI Number	:	1790610566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORDAN DEMARIS KLAFFER MA, PLPC

Provider Business Mailing Address
First Line	:	2528 SINGING HILLS DR
Second Line	:
City	:	CAPE GIRARDEAU
State	:	MO
Zip	:	63701-2020
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3037 LEXINGTON AVE
Second Line	:
City	:	CAPE GIRARDEAU
State	:	MO
Zip	:	63701-2602
Country	:	US
Telephone Number	:	573-271-2008
Fax Number	:

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

Provider Enumeration Date	:	06/15/2026
Last Update Date	:	06/15/2026

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