Millicent C. Jordan, LLC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

328 Issued in SC

Legal business name

MILLICENT C. JORDAN, LLC

Practice address

1 Carriage LN Ste J
Charleston, SC 29407-6060

Phone

(843) 573-5050

Fax

(843) 573-5030

NPI assigned

Nov 14, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Millicent Jordan, LPC

Title

Director

Phone

(843) 573-5050

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ashley Therapy Associates Doing business as

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457423535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CARRIAGE LN STE 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 STE J",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294076060",
            "telephone_number": "843-573-5050",
            "fax_number": "843-573-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLICENT C. JORDAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "MILLICENT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "843-573-5050",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "SC",
            "license": "328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202569",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ashley Therapy Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah Nicole Miller, PHD, RN
• Shavon Caron Miller, RBT
• Thomas Edward Miller III, M.D.
• Amy M Millett, NP
• Millicent C. Jordan, LLC
• Laura Milligan, NP
• Cole Milliken, MD
• Elizabeth Koutoufas Milliron, M.D.
• Matthew John Milliron, M.D.
• Alexandra Mills, M.D.

• Counseling Psychologist in Charleston, SC
• Providers in Charleston, SC by specialty
• Counseling Psychologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.