Provider Demographics
NPI:1821601501
Name:GRAHAM, JORDAN FRANCES (PLMHP)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:FRANCES
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5025 GARLAND ST STE C024
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-2904
Mailing Address - Country:US
Mailing Address - Phone:402-476-3200
Mailing Address - Fax:
Practice Address - Street 1:5025 GARLAND ST STE C024
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504-2904
Practice Address - Country:US
Practice Address - Phone:402-476-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-24
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical