Danielle Alene Jordan, PH.D., L.P.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP4394 Issued in MN

Practice address

120 Labree Ave S
Thief River Falls, MN 56701-2840

Phone

(218) 683-4351

Fax

(218) 683-4362

NPI assigned

Jan 26, 2007

Last updated

May 6, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Center for Psychological Services for Twin Cities, PA

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Paul, MN
  • NPI 1417941063
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273104000000",
    "number": "1093861379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 MERRIAM AVE N",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "567012334",
            "telephone_number": "651-735-4841",
            "fax_number": "651-735-8470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 LABREE AVE S",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "567012840",
            "telephone_number": "218-683-4351",
            "fax_number": "218-683-4362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "DANIELLE",
        "middle_name": "ALENE",
        "name_prefix": "Dr.",
        "credential": "PH.D., L.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2010-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP4394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cole Daniel Johnson, DDS
• Jenae Mayre Johnson
• Liberty Johnson
• Nowell Johnson, FNP-C
• Rozlynn O'Lee Johnsrud
• Andrea Marie Jorgenson, CNP
• Katherine Joseph, MD
• Sherrie Ann Kahn, PSYD
• Kenton Dayle Kainz, D.C.
• Lisa Joyce Keller Salvaggio, PSY.D., LP

• Clinical Psychologist in Thief River Falls, MN
• Providers in Thief River Falls, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.