Provider Demographics
NPI:1780160531
Name:MADISON, JORDAN ASHLEY (LCMFT)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:ASHLEY
Last Name:MADISON
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8705 COLESVILLE RD STE 136
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3903
Mailing Address - Country:US
Mailing Address - Phone:917-528-1405
Mailing Address - Fax:
Practice Address - Street 1:8705 COLESVILLE RD STE 136
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3903
Practice Address - Country:US
Practice Address - Phone:301-327-2793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-16
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCM772106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist