Provider Demographics
NPI:1033674338
Name:GONZALES, JORDAN ELESE (LPC)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:ELESE
Last Name:GONZALES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9600 E GIRARD AVE APT 6B
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-5023
Mailing Address - Country:US
Mailing Address - Phone:225-323-6447
Mailing Address - Fax:
Practice Address - Street 1:9600 E GIRARD AVE APT 6B
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-5023
Practice Address - Country:US
Practice Address - Phone:720-588-8361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-31
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0019142101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional