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Individual
JORDAN B KILLPACK
Active
Individual
JORDAN B KILLPACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MC, LPC, CMHC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
20280
TX
101Y00000X
Counselor
5422738-6004
UT
101YA0400X
Addiction (Substance Use Disorder) Counselor
20280
TX
101YA0400X
Addiction (Substance Use Disorder) Counselor
5422738-6004
UT
101YM0800X
Mental Health Counselor
Primary
20280
TX
101YM0800X
Mental Health Counselor
5422738-6004
UT
101YP2500X
Professional Counselor
20280
TX
101YP2500X
Professional Counselor
5422738-6004
UT
Other
Enumeration date
06/19/2006
Last updated
07/21/2022
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