Jordan Watkins, LISW-CP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

753 Johnnie Dodds Blvd
Mt Pleasant, SC 29464-3054

Phone

(864) 921-0744

NPI assigned

Jul 24, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Alive & Well Counseling, LLC

  • Clinical Social Worker
  • Mt Pleasant, SC
  • NPI 1356956650
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1595548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1265041313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4841 CHERRY BLOSSOM DR",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858732",
            "telephone_number": "864-921-0744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "753 JOHNNIE DODDS BLVD",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643054",
            "telephone_number": "864-921-0744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "JORDAN",
        "name_prefix": "Mrs.",
        "credential": "LISW-CP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-24",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy S Warner, MD
• Faith Warren, LPC
• Susan Yarborough Warren, LPC
• Colene L Watkins, PA-C
• Hollyn Elizabeth Watkins, M.S. CCC-SLP
• Charlene Watson
• Courtney Diane Watson, PHARMD
• Jessica Leigh Watson, PA-C
• Joshua Thomas Watson, M.D.
• Nichole McCullough Watson, M.D.

• Clinical Social Worker in Mt Pleasant, SC
• Providers in Mt Pleasant, SC by specialty
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.