Provider Demographics
NPI:1891440475
Name:JORDY, JEFFREY LEE (LCSW)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:LEE
Last Name:JORDY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 30TH AVE N APT 301
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1583
Mailing Address - Country:US
Mailing Address - Phone:505-585-1113
Mailing Address - Fax:
Practice Address - Street 1:210 30TH AVE N APT 301
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1583
Practice Address - Country:US
Practice Address - Phone:505-585-1113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-13
Last Update Date:2022-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW021943101YM0800X
NMC-12097101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health