Provider Demographics
NPI:1982430633
Name:JORDAN, LAUREN (RMFTI)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:JORDAN
Suffix:
Gender:F
Credentials:RMFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1175 NE 125TH ST STE 320
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-5010
Mailing Address - Country:US
Mailing Address - Phone:305-209-2662
Mailing Address - Fax:
Practice Address - Street 1:1175 NE 125TH ST STE 320
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-5010
Practice Address - Country:US
Practice Address - Phone:305-209-2662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist