# KIMBERLY MICHELLE JORDAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1285873745
- **Gender:** F
- **Credential:** LADAC, LMFT, CPRP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 014701 | NM | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | RI-J0811051803 | CA | — |
| 106H00000X | Marriage & Family Therapist | 0176661 | NM | Yes |
| 171M00000X | Case Manager/Care Coordinator | 171007 | NM | — |
| 172V00000X | Community Health Worker | 171007 | NM | — |

## Other

- **Enumeration date:** 02/06/2009
- **Last updated:** 09/22/2015