Provider Demographics
NPI:1568516128
Name:JORDAN, LAUREN BRAND (LMSW)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:BRAND
Last Name:JORDAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7557 RAMBLER RD
Mailing Address - Street 2:SUITE 612
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4142
Mailing Address - Country:US
Mailing Address - Phone:214-692-6100
Mailing Address - Fax:214-739-6240
Practice Address - Street 1:7557 RAMBLER RD
Practice Address - Street 2:SUITE 612
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4142
Practice Address - Country:US
Practice Address - Phone:214-692-6100
Practice Address - Fax:214-739-6240
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS14177101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health