Provider Demographics
NPI:1093898926
Name:JORDAN, SUSAN KLECK (LPC)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:KLECK
Last Name:JORDAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:KLECK
Other - Last Name:JORDAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:900 TRAIL RIDGE RD STE 126
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-7765
Mailing Address - Country:US
Mailing Address - Phone:803-998-8008
Mailing Address - Fax:
Practice Address - Street 1:900 TRAIL RIDGE RD FL 1
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-7765
Practice Address - Country:US
Practice Address - Phone:803-998-8008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8046101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional