Individual
NICHOLE JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M. COUN., LCPC, NCC
Contact information
Practice address
3350 W AMERICANA TER, SUITE #215, BOISE, ID 83706-2521
(208) 342-7030
(208) 342-7030
Mailing address
3350 W AMERICANA TER, SUITE #215, BOISE, ID 83706-2521
(208) 342-7030
(208) 342-7030
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-4471
ID
101YP2500X
Professional Counselor
LCPC-4471
ID
Other
Enumeration date
08/07/2009
Last updated
07/17/2011
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