Individual provider · Type 1 NPI

Terry Glen Jordan, MS, LPC

Mental Health Counselor · Lake Providence, LA

NPI number 1063008712 Active

Practice location

500 Lake St Ste B
Lake Providence, LA 71254-2550

Call (318) 552-5016 Map

Mailing address

PO Box 1307
Oak Grove, LA 71263-1307

Other practice locations

  • 144 Horton Ln, Oak Grove, LA 71263-8668 · (318) 680-4683

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor 101YP2500X8116 (LA)
Mental Health Counselor Primary 101YM0800X8116 (LA)

Mental Health Counselor: Definition to come...

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About NPI 1063008712

Terry Glen Jordan, MS, LPC's National Provider Identifier is 1063008712, issued on Dec 16, 2020. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Lake Providence, LA. The record was last updated on Jul 5, 2023.