Jordan Conrad, PHD, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

092469 Issued in NY

Practice address

1123 Broadway
New York, NY 10010-2007

Phone

(929) 352-0449

NPI assigned

Sep 19, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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.

• Jordan a. Conrad, L.C.S.W., P.C.

  • Clinical Social Worker
  • New York, NY
  • NPI 1366200198
  NPD Authorized official

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

{
    "created_epoch": "1537315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1265916902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 BROADWAY STE 308",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100102093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100102007",
            "telephone_number": "929-352-0449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "PHD, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-19",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "092469",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "103802-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia A Connors, CRNA
• Rebecca K Connors, MS CCC-SLP
• Thomas Connors
• Kelly Conover
• Gregg A Conrad, D.D.S.
• Kelsey Conrad, NP
• Julia Annika Conrath, PH.D.
• Emma Conroy
• Jennifer Marie Conroy, MD
• Kara Conroy

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.