Organization
AUTHENTIC CONNECTION SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY JOSEPH JORDAN LCPC (OWNER/MANAGER)
(314) 757-7241
Entity
Organization
Contact information
Practice address
1643 W FARRAGUT AVE APT 1, CHICAGO, IL 60640-0881
(314) 757-7241
Mailing address
1643 W FARRAGUT AVE APT 1, CHICAGO, IL 60640-0881
(314) 757-7241
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
11/10/2023
Last updated
11/10/2023
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