Amanda S Jordan, PSYD

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

37404 Issued in TX

Practice address

10601 N Riverside Dr
Keller, TX 76244-2118

Phone

(817) 347-2600

Fax

(817) 347-2610

NPI assigned

Aug 23, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ajordan14771@cookchildrens.direct-ci.com

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.

• Cook Children's Medical Center

  • Clinical Child & Adolescent Psychologist
  • Fort Worth, TX
  • NPI 1710702907
  Medicare reassignment NPD
• Cook Children's Medical Center

  dba Teddy Bear Transport

  • Air Ambulance
  • Fort Worth, TX
  • NPI 1215907530
  NPD
• Cook Children's Medical Center

  dba Cook Children's Behavioral Health

  • Clinical Child & Adolescent Psychologist
  • Fort Worth, TX
  • NPI 1942509963
  NPD (past)

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

{
    "created_epoch": "1471910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1194270884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99213",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761990213",
            "telephone_number": "828-851-8606",
            "fax_number": "682-885-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10601 N RIVERSIDE DR",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762442118",
            "telephone_number": "817-347-2600",
            "fax_number": "817-347-2610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "AMANDA",
        "middle_name": "S",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-23",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "TX",
            "license": "37404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ajordan14771@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "901 7th Ave",
            "address_2": "STE 2100",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761042722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dejonet Jones
• Jacqueline Jones, RBT
• Jeffrey E Jones, LPC
• Megan L Jones, CCC-SLP
• Rachel Jeanette Jones, LMFT
• Ariel Desiree Jordan
• JS Aesthetics Consulting, LLC
• Shalontae A Kagler
• Kevin J. Kallal, M.D.
• Elizabeth Ann Kane-Torres, FNP-C

• Counseling Psychologist in Keller, TX
• Providers in Keller, TX by specialty
• Counseling Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; 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.

Verify at the official NPI Registry.