Jordan Woolman, LISW

Primary specialty

CounselorTaxonomy code 101Y00000X

License

911AA9974 Issued in IA

Practice address

1680 SW Ankeny Rd Ste 1a
Ankeny, IA 50023-8270

Phone

(515) 344-4126

Fax

(515) 219-4582

NPI assigned

Oct 8, 2012

Last updated

Oct 29, 2024By the provider in NPPES

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

Other names 1

• Jordan Samuelson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1285986711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1527 DE WOLF ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503162721",
            "telephone_number": "515-971-4497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 SW ANKENY RD STE 1A",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500238270",
            "telephone_number": "515-344-4126",
            "fax_number": "515-219-4582"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1527 De Wolf St",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "503162721",
            "country_code": "US",
            "telephone_number": "515-971-4497",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2825 S Ankeny Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Ankeny",
            "state": "IA",
            "postal_code": "500239417",
            "country_code": "US",
            "telephone_number": "515-344-4126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOOLMAN",
        "first_name": "JORDAN",
        "name_prefix": "Mrs.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-08",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IA",
            "license": "911AA9974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "SAMUELSON",
            "credential": "BA, MSW, LISW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Nicholas Woolley
• William Edward Wortman, MD
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• Patricia Yavitz, LMHC
• Scott Yegge
• Austin Yoakum, LMHC

• Counselor in Ankeny, IA
• Providers in Ankeny, IA by specialty
• Counselor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.