Active NPI
Cortez Trenton Jordan, LLPC
- Professional Counselor
- Clinton Township, MI
National Provider Identifier
1376352294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6451024079
- Practice address
- 15600 19 Mile Rd
Clinton Township, MI 48038-3502 - Phone
- (586) 263-8700
- NPI assigned
- Jan 6, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6451024079 | MI | Primary |
Addresses
Primary practice location
15600 19 Mile Rd
Clinton Township, MI 48038-3502
Mailing address
9654 Grandmont Ave
Detroit, MI 48227-1073
Phone (313) 221-0729
Other practice location 1
2520 Packard Rd Ste 4
Ypsilanti, MI 48197-2245
Phone (734) 480-8099
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6451024079 | MI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prosperity Counseling and Supervision, LLC | Current | Accepting new patients |
Locations
2520 Packard Rd
Ste 4
Ypsilanti, MI 48197
Phone (734) 219-5015
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Counselor
- Ypsilanti, MI
- NPI 1073198859
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738540800000",
"number": "1376352294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9654 GRANDMONT AVE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482271073",
"telephone_number": "313-221-0729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15600 19 MILE RD",
"city": "CLINTON TOWNSHIP",
"state": "MI",
"postal_code": "480383502",
"telephone_number": "586-263-8700"
}
],
"practiceLocations": [
{
"address_1": "2520 Packard Rd Ste 4",
"address_purpose": "LOCATION",
"city": "Ypsilanti",
"state": "MI",
"postal_code": "481972245",
"country_code": "US",
"telephone_number": "734-480-8099",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JORDAN",
"first_name": "CORTEZ",
"middle_name": "TRENTON",
"credential": "LLPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-01-06",
"last_updated": "2025-02-03",
"certification_date": "2025-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6451024079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clinton Township, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.