Provider Demographics
NPI:1730590449
Name:JORDAN, STEPHANIE (MA, LPCC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:JORDAN
Suffix:
Gender:
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11437 CUMBERLAND FALLS HWY
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-7821
Mailing Address - Country:US
Mailing Address - Phone:859-893-1163
Mailing Address - Fax:606-620-4410
Practice Address - Street 1:11437 CUMBERLAND FALLS HWY
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-7821
Practice Address - Country:US
Practice Address - Phone:859-893-1163
Practice Address - Fax:606-620-4410
Is Sole Proprietor?:No
Enumeration Date:2014-05-15
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY262446101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional