Katoya Jordan, LCSWA, LCASA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P014924 Issued in NC

Practice address

9486 NC-305
Jackson, NC 27845

Phone

(252) 534-1088

Fax

(252) 534-1288

NPI assigned

Feb 1, 2021

Last updated

Feb 1, 2021By 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 2

Addresses

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": "1612137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1346831435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2269 STANTONSBURG RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278342841",
            "telephone_number": "252-439-0700",
            "fax_number": "252-439-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9486 NC-305",
            "city": "JACKSON",
            "state": "NC",
            "postal_code": "27845",
            "telephone_number": "252-534-1088",
            "fax_number": "252-534-1288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "312 Academy St S Ste B",
            "address_purpose": "LOCATION",
            "city": "Ahoskie",
            "state": "NC",
            "postal_code": "279103200",
            "country_code": "US",
            "telephone_number": "252-534-1088",
            "fax_number": "252-534-1288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "KATOYA",
        "name_prefix": "Mrs.",
        "credential": "LCSWA, LCASA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-01",
        "last_updated": "2021-02-01",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-26600",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P014924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Jackson, NC
• Providers in Jackson, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.