Provider Demographics
NPI:1346418431
Name:WHITE, JORDAN A X (LCSW)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:A
Last Name:WHITE
Suffix:X
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 S KUNER RD
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80601-2864
Mailing Address - Country:US
Mailing Address - Phone:303-808-9462
Mailing Address - Fax:
Practice Address - Street 1:605 S KUNER RD
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-2864
Practice Address - Country:US
Practice Address - Phone:303-808-9462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-12
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CO099236701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor