Provider Demographics
NPI:1720770100
Name:WEINERT, JORDAN (LPC-ASSOCAITE)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:WEINERT
Suffix:
Gender:F
Credentials:LPC-ASSOCAITE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 BANDERA RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78721-1516
Mailing Address - Country:US
Mailing Address - Phone:512-658-2199
Mailing Address - Fax:
Practice Address - Street 1:5750 BALCONES DR STE 202
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4269
Practice Address - Country:US
Practice Address - Phone:737-231-1540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86746101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health