Provider Demographics
NPI:1538294525
Name:JORDAN, JANIS ANDERSON (MS, LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:JANIS
Middle Name:ANDERSON
Last Name:JORDAN
Suffix:
Gender:F
Credentials:MS, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 LOVAGE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-3006
Mailing Address - Country:US
Mailing Address - Phone:512-255-3690
Mailing Address - Fax:
Practice Address - Street 1:8500 N MO PAC EXPY
Practice Address - Street 2:SUITE 814
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8375
Practice Address - Country:US
Practice Address - Phone:512-795-7709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8867101YP2500X
TX183106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist