Organization
JORDAN WAKEFIELD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN WAKEFIELD LCPC, LPC (OWNER)
(720) 773-2026
Entity
Organization
Contact information
Practice address
3434 W 29TH AVE, DENVER, CO 80211-3612
(720) 773-2026
Mailing address
PO BOX 12650, DENVER, CO 80212-0650
(312) 277-3846
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180.012130
PROFESSIONAL LICENSE
IL
Enumeration date
09/22/2022
Last updated
09/22/2022
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