Individual
JORDAN MITCHENER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2207 DELANEY DR, BURLINGTON, NC 27215-5263
(336) 684-9951
Mailing address
PO BOX 456, BURGAW, NC 28425-0456
(910) 540-2590
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-22136
NC
101YP2500X
Professional Counselor
Primary
12294
NC
101YP2500X
Professional Counselor
A12294
NC
Other
Enumeration date
11/06/2015
Last updated
03/15/2019
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