Active NPI
Jacqueline Marie Jordan, LCSW
- Social Worker
- Bloomington, IN
National Provider Identifier
1134447105
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 1117 N Jackson St
Bloomington, IN 47404-3385 - Phone
- (812) 361-8568
- Fax
- (812) 339-2932
- NPI assigned
- May 14, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
1117 N Jackson St
Bloomington, IN 47404-3385
Mailing address
1117 N Jackson St
Bloomington, IN 47404-3385
Phone (812) 361-8568
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782172800000",
"number": "1134447105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1117 N JACKSON ST",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474043385",
"telephone_number": "812-361-8568",
"fax_number": "812-339-4436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1117 N JACKSON ST",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474043385",
"telephone_number": "812-361-8568",
"fax_number": "812-339-2932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "JACQUELINE",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-14",
"last_updated": "2026-06-23",
"certification_date": "2026-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.