Millicent Clemons Jordan, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2623 Issued in SC

Practice address

1 Carriage LN
BLDG J
Charleston, SC 29407-6060

Phone

(843) 573-5050

Fax

(843) 573-5030

NPI assigned

Apr 20, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217462400000",
    "number": "1235194218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CARRIAGE LN",
            "address_2": "BLDG. J",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294076060",
            "telephone_number": "843-573-5050",
            "fax_number": "843-573-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CARRIAGE LN",
            "address_2": "BLDG J",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294076060",
            "telephone_number": "843-573-5050",
            "fax_number": "843-573-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "MILLICENT",
        "middle_name": "CLEMONS",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2008-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "2623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID HO",
            "identifier": "202569",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jillianne O'Lee Jordan, OTD, OTR/L
• Julia Montgomery Jordan, MD
• Lisa Vaughan Jordan, PHARMD
• Maranda Jordan, DO
• Mary Margaret Jordan, MD
• Rebecca Leeann Jordan
• Robert Charles Jordan, M.D., F.A.A.O.A.
• Stephanie D Jordan, CRNA
• Alexandra Susann Jorsch, RBT
• Predesh Parasseril Jose, MD

• Mental Health Counselor in Charleston, SC
• Providers in Charleston, SC by specialty
• Mental Health Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; 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.