Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jordan Tyler Lakes, MSOT

Individual provider Community Health Worker · NPI 1962856104

Jordan Tyler Lakes, MSOT is a Community Health Worker in Indianapolis, Indiana. Practices as a sole proprietor. Licensed in Indiana.

Licensed in
IN
In the registry since
2016

Practice location Address checks out

9190 Priority Way West Dr
Indianapolis, IN 46240-6426
Phone: (317) 805-4963
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community Health Worker (primary) Taxonomy 172V00000X · Licence 31006064A (IN)

Record details

NPI number1962856104
Entity typeIndividual (Type 1)
GenderMale
Credentials MSOT
Sole proprietorYes
NPI enumeratedApril 13, 2016
Last updated in NPPESApril 13, 2016

Other providers in Indianapolis