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Individual

FATIMA JORDAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC, CRC, LCASA

Contact information

Practice address
2309 W CONE BLVD STE 218, GREENSBORO, NC 27408-4047
(336) 410-4161
Mailing address
2309 W CONE BLVD STE 218, GREENSBORO, NC 27408-4047
(336) 410-4161

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
22225
NC
101YM0800X
Mental Health Counselor
Primary
A10358
NC
225C00000X
Rehabilitation Counselor
00117659
NC

Other

Enumeration date
08/12/2014
Last updated
01/24/2018
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