Active NPI
Jorge C Cordova, LCSW
- Clinical Social Worker
- Houston, TX
National Provider Identifier
1265632376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 02131
- Practice address
- 2916 W T C Jester Blvd Ste 102
Houston, TX 77018-7051 - Phone
- (713) 263-0829
- Fax
- (713) 263-9539
- NPI assigned
- Jul 18, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 02131 | TX | |
| Clinical Social Worker | 1041C0700X | 02131 | TX | Primary |
Addresses
Primary practice location
2916 W T C Jester Blvd Ste 102
Houston, TX 77018-7051
Mailing address
12623 Imperial Crossing Dr
Tomball, TX 77377-4029
Phone (281) 290-9399
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02131 | TX | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center for Counseling | Mental Health | Past | Accepting new patients |
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": "1184716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184716800000",
"number": "1265632376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12623 IMPERIAL CROSSING DR",
"city": "TOMBALL",
"state": "TX",
"postal_code": "773774029",
"telephone_number": "281-290-9399",
"fax_number": "713-263-9539"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2916 W T C JESTER BLVD STE 102",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770187051",
"telephone_number": "713-263-0829",
"fax_number": "713-263-9539"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORDOVA",
"first_name": "JORGE",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-18",
"last_updated": "2007-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "02131",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "02131",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.