Individual provider Active NPI

Jordan Jessie Housley, DSW

  • Social Worker
  • Montgomery, TX
National Provider Identifier
1013716091
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
107771 Issued in TX
Practice address
12119 Brightwood Dr
Montgomery, TX 77356-8930
Phone
(218) 343-5629
NPI assigned
Mar 11, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 107771 TX Primary

Addresses

Primary practice location

12119 Brightwood Dr
Montgomery, TX 77356-8930

Mailing address

12119 Brightwood Dr
Montgomery, TX 77356-8930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 28, 2026 through Jan 28, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
107771TXMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1741651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1013716091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12119 BRIGHTWOOD DR",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773568930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12119 BRIGHTWOOD DR",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773568930",
            "telephone_number": "218-343-5629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSLEY",
        "first_name": "JORDAN",
        "middle_name": "JESSIE",
        "name_prefix": "Dr.",
        "credential": "DSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-11",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "107771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, TX

Sources for this page

Verify at the official NPI Registry.