Provider Demographics
NPI:1275716888
Name:JORDAN, JULIE K (LMHC)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:K
Last Name:JORDAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 NORTH BABCOCK ST
Mailing Address - Street 2:#102
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-7324
Mailing Address - Country:US
Mailing Address - Phone:321-313-1745
Mailing Address - Fax:321-428-3358
Practice Address - Street 1:330 N BABCOCK ST
Practice Address - Street 2:#102
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-7324
Practice Address - Country:US
Practice Address - Phone:321-313-1745
Practice Address - Fax:321-428-3358
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-06
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 9263101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health