Individual provider Active NPI

Cortez Trenton Jordan, LLPC

  • Professional Counselor
  • Clinton Township, MI
National Provider Identifier
1376352294
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6451024079 Issued in MI
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

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
6451024079MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Prosperity Counseling and Supervision, LLC CurrentSince Jan 1, 2025 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.

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.

Verify at the official NPI Registry.