Individual
JASON TERRY JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
2611 LEE ST, GREENVILLE, TX 75401-4247
(903) 454-6334
(903) 454-1153
Mailing address
2611 LEE ST, GREENVILLE, TX 75401-4247
(903) 454-6334
(903) 454-1153
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
13295
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
128064
VALUE OPTIONS
TX
01
—
6565LC
BLUE CROSS BLUE SHIELD
TX
Enumeration date
08/11/2006
Last updated
07/08/2007
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