Jordanica Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5782C Issued in NV

Legal business name

JORDANICA INC

Practice address

780 Coronado Center Dr
Suite 110a
Henderson, NV 89052-5040

Phone

(702) 358-0464

Fax

(610) 432-3508

NPI assigned

Jan 13, 2011

Last updated

Jan 13, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark A. Premselaar, LCSWNPI 1518979889

Title

President

Phone

(702) 358-0464

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark A. Premselaar, MSW, LCSW

  • Clinical Social Worker
  • Henderson, NV
  • NPI 1518979889
  Authorized official Same address or phone

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

{
    "created_epoch": "1294876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294876800000",
    "number": "1043515570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 CORONADO CENTER DR",
            "address_2": "SUITE 110A",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525040",
            "telephone_number": "702-358-0464",
            "fax_number": "610-432-3508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 CORONADO CENTER DR",
            "address_2": "SUITE 110A",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525040",
            "telephone_number": "702-358-0464",
            "fax_number": "610-432-3508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JORDANICA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-13",
        "last_updated": "2011-01-13",
        "status": "A",
        "authorized_official_last_name": "PREMSELAAR",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-358-0464",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "5782C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ariel Jordan
• Brittany Ann Jordan, MFT
• Heather M Jordan, BA
• Michelle Margaret Jordan, DO
• Sonya Jordan
• Cristifer Jorgensen
• Laurie Jorgensen
• Zaria Jorgensen
• Jorgenson & Koka LLP (Advanced Urgent Care & Nighlight Pediatrics)
• Marcille Jorgenson, RN

• Clinical Social Worker in Henderson, NV
• Providers in Henderson, NV by specialty
• Clinical Social Worker in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.