Provider Demographics
NPI:1699813667
Name:JORDAN, KAREN M (LMSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:M
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 1:1960 LENNON ST
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-1617
Mailing Address - Country:US
Mailing Address - Phone:586-215-0727
Mailing Address - Fax:586-978-0331
Practice Address - Street 1:38800 VAN DYKE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48312-1151
Practice Address - Country:US
Practice Address - Phone:586-939-8994
Practice Address - Fax:586-978-0331
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010591371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical