Provider Demographics
NPI:1841581014
Name:URBAN, JORDAN CATHERINE (MA, LMFT)
Entity Type:Individual
Prefix:MS
First Name:JORDAN
Middle Name:CATHERINE
Last Name:URBAN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 MARTIN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-1621
Mailing Address - Country:US
Mailing Address - Phone:215-390-6908
Mailing Address - Fax:
Practice Address - Street 1:406 W MOUNT PLEASANT AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-2961
Practice Address - Country:US
Practice Address - Phone:215-390-6908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000594106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist