Provider Demographics
NPI:1356030449
Name:PACE, JOURDAN (MA)
Entity type:Individual
Prefix:
First Name:JOURDAN
Middle Name:
Last Name:PACE
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 1:4535 HARDING PIKE STE 207
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2120
Mailing Address - Country:US
Mailing Address - Phone:850-206-7065
Mailing Address - Fax:
Practice Address - Street 1:4535 HARDING PIKE STE 207
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2120
Practice Address - Country:US
Practice Address - Phone:615-637-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional