Organization
JORDAN FONSECA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN FONSECA LCSW (THERAPIST)
(317) 714-7974
Entity
Organization
Contact information
Practice address
970 LOGAN ST STE 110, NOBLESVILLE, IN 46060-2253
(317) 714-7974
Mailing address
695 JEFFERSON ST, FORTVILLE, IN 46040-1739
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
04/05/2023
Last updated
04/05/2023
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