Mandy J Jordan, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

34438 Issued in TX

Practice address

12416 Beartrap LN
Austin, TX 78729-7938

Phone

(817) 916-8200

Fax

(817) 717-6571

NPI assigned

Mar 24, 2010

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1306160080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 202636",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787202636",
            "telephone_number": "817-916-8200",
            "fax_number": "817-717-6571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12416 BEARTRAP LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787297938",
            "telephone_number": "817-916-8200",
            "fax_number": "817-717-6571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "MANDY",
        "middle_name": "J",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-24",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "34438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212411701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennefer Christine Jordan, DNP, FNP-BC
• Jennifer Jean Jordan, P.A.
• Joseph Lee Jordan
• Krista Diane Jordan, PHD
• Madeleine Marie Jordan, MD
• Ryan Jordan
• Selah Jordan
• Timothy C Jordan, CRNA
• Leah Jorgensen-Kamin, DO
• Denise Jorgensen, LPC

• Clinical Psychologist in Austin, TX
• Providers in Austin, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2021; 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.