Jacqueline D Jordan, CO

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

10081 Issued in AL

Practice address

619 19TH Street South
Birmingham, AL 35233

Phone

(205) 934-6600

NPI assigned

Jun 28, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326076522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55310",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352555310",
            "telephone_number": "205-731-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 19TH STREET SOUTH",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35233",
            "telephone_number": "205-934-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "JACQUELINE",
        "middle_name": "D",
        "credential": "CO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AL",
            "license": "10081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIVA",
            "identifier": "E92967",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Whitney Jones
• William Adam Jones, CRNP
• Jayasree Jonnadula, MD
• Bryan Jordan
• Dimari Maurice Jordan
• Jamesse S Jordan, LMSW
• Jeremy Dugger Jordan, CRNP, CPNP-AC
• Josh Jordan, PHARMD
• Katherine Cross Jordan, MS, RDN, LDN
• Keiasha Marie Jordan, CRNP

• Addiction (Substance Use Disorder) Counselor in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Addiction (Substance Use Disorder) Counselor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.