Doctor Name: | MRS. JORDAN PREBYS |
NPI Number: | 1245363225 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 2005028614 |
Business Practice Address: | 11005 Acton Dr Saint Louis, MO - 631237003 |
Business Phone Number: | 3145400545 |
Business Fax Number: | |
Mailing Address: | 610 W Lucas Dr, Suite C BEAUMONT |
State: | TX |
Postal Code: | 777064604 |
Phone Number: | 4092420084 |
Fax Number: | |
NPI Enumeration Date: | 03/13/2007 |
NPI Last Update Date: | 08/19/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 2005028614 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |