Jordan, Augustus E.

Jordan, Augustus E. is an sole proprietor health care provider with primary practice located at 152 Maple St Suite 202, Middlebury VT 05753-1370. He recently has only one registered license in Behavioral Health & Social Service Providers / Counseling, which is considered as his primary health care specialty. Jordan, Augustus E. can be contacted via phone (802) 989-1555.

Contact Information

Primary practice address
152 Maple St Suite 202 Middlebury VT 05753-1370
Phone: (802) 989-1555
Fax: (802) 443-2772
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counseling 103TC1900X 048-0000843 Vermont

Profile Details

NPI number 1639102551
LBN Legal business name Jordan, Augustus E.
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 7th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639102551 NPPES
Vermont MEDICAID 1010775
Vermont Other 68375

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