Provider Demographics
NPI:1619637998
Name:HAIGHT, JORDAN LEE (LPCC)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:LEE
Last Name:HAIGHT
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:JORDAN
Other - Middle Name:LEE
Other - Last Name:HAIGHT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPCC
Mailing Address - Street 1:221 QUAIL DR
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:MN
Mailing Address - Zip Code:55363-5439
Mailing Address - Country:US
Mailing Address - Phone:320-630-4197
Mailing Address - Fax:
Practice Address - Street 1:11334 86TH AVE N
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-4528
Practice Address - Country:US
Practice Address - Phone:763-255-2125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health