| James R Jordan Ms, Ncc, Licensed Mental Health Counselor, Pllc | |
|
595 Route 25a Suite #15 Miller Place NY 11764-2646 | |
| (631) 786-0842 | |
| Not Available |
| Full Name | James R Jordan Ms, Ncc, Licensed Mental Health Counselor, Pllc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 595 Route 25a, Miller Place, New York |
| Authorized Official Name and Position | James Raymond Jordan (OWNER) |
| Authorized Official Contact | 6317860842 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| James R Jordan Ms, Ncc, Licensed Mental Health Counselor, Pllc Po Box 63 Middle Island NY 11953-0063 Ph: (631) 786-0842 | James R Jordan Ms, Ncc, Licensed Mental Health Counselor, Pllc 595 Route 25a Suite #15 Miller Place NY 11764-2646 Ph: (631) 786-0842 |
| NPI Number | 1922340785 |
|---|---|
| Provider Enumeration Date | 03/20/2013 |
| Last Update Date | 04/30/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922340785 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 004425 (New York) | Primary |
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