Provider Demographics
NPI:1831816537
Name:KESSLER, JORDAN NIKOLE (LMFTA, LCAS-A)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:NIKOLE
Last Name:KESSLER
Suffix:
Gender:F
Credentials:LMFTA, LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:284 EXECUTIVE PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-1833
Mailing Address - Country:US
Mailing Address - Phone:704-939-1100
Mailing Address - Fax:704-939-1173
Practice Address - Street 1:360 BEECH ST
Practice Address - Street 2:
Practice Address - City:NEWLAND
Practice Address - State:NC
Practice Address - Zip Code:28657-9670
Practice Address - Country:US
Practice Address - Phone:828-733-5889
Practice Address - Fax:828-733-8743
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-28719101YA0400X
NC12412A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)