Provider Demographics
NPI:1073901013
Name:ASHLEY JORDAN
Entity Type:Organization
Organization Name:ASHLEY JORDAN
Other - Org Name:AUBURN WELLNESS PERSPECTIVE COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:334-329-6063
Mailing Address - Street 1:PO BOX 871
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36831-0871
Mailing Address - Country:US
Mailing Address - Phone:334-329-6063
Mailing Address - Fax:972-499-1005
Practice Address - Street 1:118 N ROSS ST
Practice Address - Street 2:SUITE 2
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-4869
Practice Address - Country:US
Practice Address - Phone:334-332-5214
Practice Address - Fax:334-329-6063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-29
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3680C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL102I808963OtherPTAN