| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JORDAN NICOLE PETITT | 1417547753 | 2023-02-12 |
Jordan Nicole Petitt is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1417547753. Registration indicates Jordan Nicole Petitt is a provider of access to mental health/behavioral health providers services with a specialization in Behavioral Health & Social Service Providers, Counselor (Behavioral Health & Social Service Providers, Counselor) (Counselor: Mental Health, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Counselor Mental Health, Behavioral Health & Social Service Providers) (Counselor, )
| Entity Type | Individual |
| Provider Name | Jordan Nicole Petitt LMFT |
| Practice Office Address | 2904 ROWENA AVE LOS ANGELES, CA US |
| Practice Office Telephone | 8183819723 |
| Mailing Address | 848 N CALIFORNIA ST BURBANK, CA 915052919 US |
| Business Telephone | 8189703539 |
| Code | Practice | License No State |
|---|---|---|
| 101YM0800X PRIMARY | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Counselor Behavioral Health & Social Service Providers Counselor Counselor: Mental Health Behavioral Health/Substance Abuse/Psychiatry Counselor Mental Health Behavioral Health & Social Service Providers Counselor | 137462
CA |