Provider Demographics
NPI:1194046532
Name:JORDAN, LAURIE C (LPC)
Entity type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:C
Last Name:JORDAN
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 1:810 W SOUTH 4TH ST
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:SC
Mailing Address - Zip Code:29678-3324
Mailing Address - Country:US
Mailing Address - Phone:864-886-4455
Mailing Address - Fax:864-886-4452
Practice Address - Street 1:810 W SOUTH 4TH ST
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678-3324
Practice Address - Country:US
Practice Address - Phone:864-886-4455
Practice Address - Fax:864-886-4452
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health