Individual provider · Type 1 NPI

Kevin Michael Jordan, LCDC

Addiction (Substance Use Disorder) Counselor · Tyler, TX

NPI number 1801595574 Active

Practice location

1827 W Gentry Pkwy
Tyler, TX 75702-3929

Call (903) 630-7461 Map

Mailing address

715 Estes Dr
Longview, TX 75602-6102

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X13944 (TX)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1801595574

Kevin Michael Jordan, LCDC's National Provider Identifier is 1801595574, issued on Mar 1, 2023. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Tyler, TX. The record was last updated on Mar 1, 2023.