Provider Demographics
NPI:1598786808
Name:JORDAN, CYNDI (LPC, SLPE-HSP)
Entity Type:Individual
Prefix:DR
First Name:CYNDI
Middle Name:
Last Name:JORDAN
Suffix:
Gender:F
Credentials:LPC, SLPE-HSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 W BROOKHAVEN CIR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-4504
Mailing Address - Country:US
Mailing Address - Phone:901-531-7200
Mailing Address - Fax:901-755-3302
Practice Address - Street 1:716 W BROOKHAVEN CIR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-4504
Practice Address - Country:US
Practice Address - Phone:901-531-7200
Practice Address - Fax:901-755-3302
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN608101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional