Provider Demographics
NPI:1417564543
Name:MCDOWELL, JORDAN RENAE (MA, LPC-CANDIDATE)
Entity Type:Individual
Prefix:MRS
First Name:JORDAN
Middle Name:RENAE
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:MA, LPC-CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 S FRETZ AVE STE C
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-5568
Mailing Address - Country:US
Mailing Address - Phone:405-726-9808
Mailing Address - Fax:405-726-9809
Practice Address - Street 1:425 S FRETZ AVE STE C
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73003-5568
Practice Address - Country:US
Practice Address - Phone:405-726-9808
Practice Address - Fax:405-726-9809
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty