MEDICARE: JORDAN STAHL

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	104100000X	Social Worker	6851121427	MI

General Provider Information

NPI Number	:	1952260457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORDAN STAHL

Provider Business Mailing Address
First Line	:	117 N DIVISION ST STE 1
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48104-1580
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 N WEST AVE
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49202-2179
Country	:	US
Telephone Number	:	517-796-4524
Fax Number	:

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

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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Directions to “ JORDAN STAHL ” Practice Location

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