Individual
JAMES RAYMOND JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, NCC, LMHC,DCC
Contact information
Practice address
595 ROUTE 25A, SUITE #15, MILLER PLACE, NY 11764-2646
(631) 786-0842
(631) 775-9284
Mailing address
PO BOX 63, MIDDLE ISLAND, NY 11953-0063
(631) 608-5202
(631) 264-4509
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
08/04/2011
Last updated
04/30/2015
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