Provider Demographics
NPI:1447730361
Name:PARKER, JORDAN PAIGE (MED, ALC, NCC)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:PAIGE
Last Name:PARKER
Suffix:
Gender:F
Credentials:MED, ALC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 VILLAGE PARKWAY
Mailing Address - Street 2:PESEK COUNSELING SERVICES
Mailing Address - City:HELENA
Mailing Address - State:AL
Mailing Address - Zip Code:35080-4028
Mailing Address - Country:US
Mailing Address - Phone:205-624-3076
Mailing Address - Fax:844-835-1972
Practice Address - Street 1:277 VILLAGE PKWY
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:AL
Practice Address - Zip Code:35080-4028
Practice Address - Country:US
Practice Address - Phone:205-624-3076
Practice Address - Fax:844-835-1972
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC2942A101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor