Provider Demographics
NPI:1538999693
Name:SEMPLE, JORDAN ELIZABETH (MS, LCPC-C)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:ELIZABETH
Last Name:SEMPLE
Suffix:
Gender:X
Credentials:MS, LCPC-C
Other - Prefix:
Other - First Name:DANNY
Other - Middle Name:
Other - Last Name:SEMPLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:13 WENTWORTH LN
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-1563
Mailing Address - Country:US
Mailing Address - Phone:774-254-6974
Mailing Address - Fax:
Practice Address - Street 1:50 DEPOT RD STE 2
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1211
Practice Address - Country:US
Practice Address - Phone:207-835-3616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL7704101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health