Provider Demographics
NPI:1689951923
Name:FAIMAN, JORDAN S (MA, LPC)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:S
Last Name:FAIMAN
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 NORTH AVE E STE 1A
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-2461
Mailing Address - Country:US
Mailing Address - Phone:908-913-7704
Mailing Address - Fax:908-325-7793
Practice Address - Street 1:340 NORTH AVE E STE 1A
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-2461
Practice Address - Country:US
Practice Address - Phone:908-913-7704
Practice Address - Fax:908-325-7793
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-15
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00431200101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional