Individual provider Active NPI

Hallie Ray Jordan, PHD

  • Clinical Psychologist
  • New Orleans, LA
National Provider Identifier
1073245197
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
621129 Issued in MS
Practice address
2400 Canal St
New Orleans, LA 70119-6535
Phone
(504) 507-2000
NPI assigned
Jun 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 621129 MS Primary

Addresses

Primary practice location

2400 Canal St
New Orleans, LA 70119-6535

Mailing address

1213 Mandolin St
New Orleans, LA 70122-1816
Phone (810) 610-3413

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240613000073 FL Practitioner - Clinical Psychologist 1254873532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychological Associates, P.aGroup PAC ID 1052388014, 10 clinicians

Practice addresses (Care Compare)

1120 N Palafox St
Pensacola, FL 32501-2608
Phone (850) 434-5033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
621129MSMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Associates, P.a. Clinical CurrentSince Jun 1, 2024 Accepting new patients

Locations

1120 N Palafox St
Pensacola, FL 32501
Phone (850) 434-5033

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1656374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1073245197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 MANDOLIN ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701221816",
            "telephone_number": "810-610-3413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 CANAL ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701196535",
            "telephone_number": "504-507-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "HALLIE",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-28",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MS",
            "license": "621129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.