Stephanie Elizabet Jordan, LADC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · North Mankato, MN

NPI 1669958419 · NPPES record last updated Sep 29, 2023

Key facts

NPI
1669958419
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
305187 (MN)
Practice address
1826 Commerce Dr
North Mankato, MN 56003-1800
Phone
(507) 229-0350
Fax
(507) 216-0371
NPI assigned
Jul 16, 2018
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
305187MNMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mankato Chemical Health, LLC Addiction (Substance Use Disorder) Current
since Jul 1, 2023
Accepting new patients

Locations

360 Pierce Ave
Ste 206
North Mankato, MN 56003
Phone (507) 229-0350

1826 Commerce Dr
North Mankato, MN 56003
Phone (507) 229-0350

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 305187 MN Yes

Addresses

Primary practice location

1826 Commerce Dr
North Mankato, MN 56003-1800

Mailing address

360 Pierce Ave Ste 206
North Mankato, MN 56003-2250
Phone (507) 229-0350

Other providers in North Mankato, MN

All providers in North Mankato, MN · Addiction (Substance Use Disorder) Counselor in Minnesota

Sources for this page

Verify at the official NPI Registry.