Provider Demographics
NPI:1497232631
Name:FAULKNER LAMB, JORDAN (LPC-S)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:FAULKNER LAMB
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2407 LINWOOD DR STE 4
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-6206
Mailing Address - Country:US
Mailing Address - Phone:870-573-9436
Mailing Address - Fax:
Practice Address - Street 1:2407 LINWOOD DR STE 4
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-6206
Practice Address - Country:US
Practice Address - Phone:870-573-9436
Practice Address - Fax:870-212-4045
Is Sole Proprietor?:No
Enumeration Date:2018-07-20
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP2012128101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR259283719Medicaid