Provider Demographics
NPI:1326545864
Name:SHIFLETT, JORDAN ASHLEY (LPC-MHSP)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:ASHLEY
Last Name:SHIFLETT
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:JORDAN
Other - Middle Name:
Other - Last Name:HANSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC-MHSP
Mailing Address - Street 1:5000 CROSSINGS CIRCLE SUITE 103
Mailing Address - Street 2:
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122
Mailing Address - Country:US
Mailing Address - Phone:615-208-9549
Mailing Address - Fax:
Practice Address - Street 1:5000 CROSSINGS CIRCLE SUITE 103
Practice Address - Street 2:
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-6405
Practice Address - Country:US
Practice Address - Phone:615-208-9549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6604101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health