Provider Demographics
NPI:1982189700
Name:CART, JORDAN E (MA)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:E
Last Name:CART
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 E WARD ST APT 417
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53207-1373
Mailing Address - Country:US
Mailing Address - Phone:574-322-2161
Mailing Address - Fax:
Practice Address - Street 1:15 SPINNING WHEEL RD STE 426
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-7671
Practice Address - Country:US
Practice Address - Phone:630-323-3050
Practice Address - Fax:630-323-3058
Is Sole Proprietor?:No
Enumeration Date:2018-09-27
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4148226101YP2500X
IL071010699103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional