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JOHNNY LEE JORDAN
NPI 1891359634
Peer Specialist in Saint Joseph, MI

Active since April 26, 2019
4032 M 139 STE 108, SAINT JOSEPH, MI 49085(269) 556-1526 Get Directions Write a Review

NPPES record last updated: April 26, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Johnny Lee Jordan NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHNNY LEE JORDAN (NPI 1891359634) is an individual peer specialist in Saint Joseph, Michigan and active in the NPI registry since April 2019.

NPPES Registry Identity

NPI1891359634
Entity TypeIndividualMale
Primary Taxonomy175T00000X
Provider Legal NameJOHNNY LEE JORDAN
Location Address4032 M 139 STE 108Saint Joseph, MI 49085-8664
Mailing Address4032 M 139 Ste 108Saint Joseph, MI 49085-8664 · (269) 556-1526
Phone(269) 556-1526
Sole ProprietorNo
Enumeration DateApril 26, 2019
✔ NPI 1891359634 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
4032 M 139 STE 108, Saint Joseph, MI 49085
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Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRIDGETTE A BUTLER
Nurse's Aide
4032 M 139 STE 108
SAINT JOSEPH, MI 49085
Berrien County (269) 556-1526
MEGHAN DONNELLE DAWSON
Peer Specialist
4032 M 139 STE 108
SAINT JOSEPH, MI 49085
Berrien County (269) 556-1526
LAKISHA ALLEN
Nurse's Aide
4032 M 139 STE 108
SAINT JOSEPH, MI 49085
Berrien County (269) 556-1526
LEEANN C STAGGS
Peer Specialist
4032 M 139 STE 108
SAINT JOSEPH, MI 49085
Berrien County (269) 556-1526
FRED HENRY FRESE
Peer Specialist
4032 M 139 STE 108
SAINT JOSEPH, MI 49085
Berrien County (269) 556-1526
KAROL LYNN DEBOER
Peer Specialist
4032 M 139 STE 108
SAINT JOSEPH, MI 49085
Berrien County (269) 556-1526

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Johnny Jordan's NPI number?

The NPI number for Johnny Jordan is 1891359634. It was assigned to this individual provider in the NPPES registry on April 26, 2019.

Where is Johnny Jordan located?

Johnny Jordan practices at 4032 M 139 Ste 108, Saint Joseph, MI 49085. The listed phone number is (269) 556-1526.

What is Johnny Jordan's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Johnny Jordan was last updated on April 26, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.