Provider Demographics
NPI:1417719915
Name:SUSAN K JORDAN COUNSELING
Entity Type:Organization
Organization Name:SUSAN K JORDAN COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:KLECK
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:803-998-8008
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty