Tre Jordan

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

19853 Outer Dr Ste 110
Dearborn, MI 48124-2044

Phone

(313) 406-5056

Fax

(248) 712-4381

NPI assigned

Jun 15, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1529020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654992000000",
    "number": "1801380654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19853 OUTER DR STE 110",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242044",
            "telephone_number": "313-406-5056",
            "fax_number": "248-712-4381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19853 OUTER DR STE 110",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242044",
            "telephone_number": "313-406-5056",
            "fax_number": "248-712-4381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Renaissance Ctr Ste 2600",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482431502",
            "country_code": "US",
            "telephone_number": "855-832-6727 x1696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "TRE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-15",
        "last_updated": "2022-06-12",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamiya D Jones
• Theodore Benjamin Jones, MD
• Ziyah Aree Jones
• Lakeisha Jordan, LPC
• Sherron Damien Jordan
• Joseph C Finch DO PC
• Joseph S Bassett, MD, PLC
• Carrie M Joseph, LMSW
• Nada M Joudi
• Mohammad Joujeh

• Behavior Analyst in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Behavior Analyst in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2022; 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.