Provider Demographics
NPI:1275674558
Name:JORDAN, DANIEL JOHN (NCC, LPC, CCTP)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:JOHN
Last Name:JORDAN
Suffix:
Gender:M
Credentials:NCC, LPC, CCTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 GREEN HILL RD
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-2026
Mailing Address - Country:US
Mailing Address - Phone:610-761-0084
Mailing Address - Fax:
Practice Address - Street 1:152 GREEN HILL RD
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-2026
Practice Address - Country:US
Practice Address - Phone:610-761-0084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2023-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-11999101Y00000X
PAPC004792101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor