MEDICARE: NJORDANCOUNSELING

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	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1891566253
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NJORDANCOUNSELING

Provider Business Mailing Address
First Line	:	6615 FLORA AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64131-1409
Country	:	US
Telephone Number	:	816-514-1087
Fax Number	:

Provider Business Practice Location Address
First Line	:	6615 FLORA AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64131-1409
Country	:	US
Telephone Number	:	816-514-1087
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST/OWNER
Name	:	NICHOLAS JORDAN
Credential	:	MA, LPC
Telephone Number	:	816-514-1087

Provider Enumeration Date	:	01/12/2024
Last Update Date	:	02/16/2024

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Directions to “NJORDANCOUNSELING ” Practice Location

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