Provider Demographics
NPI:1427391507
Name:BRATT, JORDAN DAVID (LPC)
Entity Type:Individual
Prefix:MR
First Name:JORDAN
Middle Name:DAVID
Last Name:BRATT
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 W 94TH TER STE 200
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66207-2521
Mailing Address - Country:US
Mailing Address - Phone:913-383-8100
Mailing Address - Fax:913-648-8316
Practice Address - Street 1:5200 W 94TH TER STE 200
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66207-2521
Practice Address - Country:US
Practice Address - Phone:913-383-8100
Practice Address - Fax:913-648-8316
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3037101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional