Jordan, Traci L

Jordan, Traci L is an sole proprietor health care provider with primary practice located at 1210 Fourier Dr Ste 100 , Madison WI 53717-1969. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / School. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Jordan, Traci L can be contacted via phone (608) 662-9327.

Contact Information

Primary practice address
1210 Fourier Dr Ste 100 Madison WI 53717-1969
Phone: (608) 662-9327
Fax: (608) 662-9041
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 005597 Arizona
Behavioral Health & Social Service Providers / Psychologist 103T00000X 0006061 Colorado
Behavioral Health & Social Service Providers / Clinical 103TC0700X 24625 Texas
Behavioral Health & Social Service Providers / School 103TS0200X 30404 Texas
Behavioral Health & Social Service Providers / Psychologist 103T00000X 5154 Wisconsin

Profile Details

NPI number 1205851995
LBN Legal business name Jordan, Traci L
Credentials PSY.D., L.S.S.P.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 13th, 2006
Last updated Jan 12th, 2024 - about last year

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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