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Individual

CRAIG ALAN JORDAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.A.

Contact information

Practice address
901 NE INDEPENDENCE AVE, LEES SUMMIT, MO 64086-5544
(816) 347-3297
(816) 347-3020
Mailing address
108 SW MADISON ST, LEES SUMMIT, MO 64063-2223
(816) 404-6319
(816) 404-6318

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2132
MO
101YP2500X
Professional Counselor
Primary
2007008570
MO

Other

Enumeration date
08/25/2006
Last updated
01/19/2010
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