Provider Demographics
NPI:1346518503
Name:JANET GILCHRIST JORDAN PHD PLLC
Entity Type:Organization
Organization Name:JANET GILCHRIST JORDAN PHD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:GILCHRIST
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:248-563-2290
Mailing Address - Street 1:628 E PARENT AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-3766
Mailing Address - Country:US
Mailing Address - Phone:248-563-2290
Mailing Address - Fax:248-543-4440
Practice Address - Street 1:628 E PARENT AVE STE 109
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-3766
Practice Address - Country:US
Practice Address - Phone:248-563-2290
Practice Address - Fax:248-543-4440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-02
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301011483103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty