Individual
KIMBERLY MICHELLE JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADAC, LMFT, CPRP
Contact information
Practice address
1215 NEW YORK AVE, ALAMOGORDO, NM 88310-6727
(575) 649-8518
Mailing address
1215 NEW YORK AVE, ALAMOGORDO, NM 88310-6727
(575) 649-8518
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
014701
NM
101YA0400X
Addiction (Substance Use Disorder) Counselor
RI-J0811051803
CA
106H00000X
Marriage & Family Therapist
Primary
0176661
NM
171M00000X
Case Manager/Care Coordinator
171007
NM
172V00000X
Community Health Worker
171007
NM
Other
Enumeration date
02/06/2009
Last updated
09/22/2015
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