Provider Demographics
NPI:1467004879
Name:TASKER, JORDAN RILEY (LLPC)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:RILEY
Last Name:TASKER
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:JORDAN
Other - Middle Name:RILEY
Other - Last Name:SARGENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLPC
Mailing Address - Street 1:1955 W HAMLIN RD STE 101
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-3338
Mailing Address - Country:US
Mailing Address - Phone:248-301-6455
Mailing Address - Fax:
Practice Address - Street 1:1955 W HAMLIN RD STE 101
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-3338
Practice Address - Country:US
Practice Address - Phone:248-301-6455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-15
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty