Active NPI
Brian Joseph Jordan, LCSW
- Clinical Social Worker
- Media, PA
National Provider Identifier
1356754469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CW012513
- Practice address
- 1055 E Baltimore Pike
Suite 300
Media, PA 19063-5173 - Phone
- (610) 892-3800
- Fax
- (484) 468-1412
- NPI assigned
- Jun 5, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CW012513 | PA | Primary |
Addresses
Primary practice location
1055 E Baltimore Pike
Suite 300
Media, PA 19063-5173
Mailing address
1724 Calamia Dr
Norristown, PA 19401-3148
Phone (484) 250-1064
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CW012513 | PA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Delaware County Professional Services, Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychiatry Physician
- Media, PA
- NPI 1952485864
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401926400000",
"number": "1356754469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1724 CALAMIA DR",
"city": "NORRISTOWN",
"state": "PA",
"postal_code": "194013148",
"telephone_number": "484-250-1064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 E BALTIMORE PIKE",
"address_2": "SUITE 300",
"city": "MEDIA",
"state": "PA",
"postal_code": "190635173",
"telephone_number": "610-892-3800",
"fax_number": "484-468-1412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "BRIAN",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-06-05",
"last_updated": "2014-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "CW012513",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Media, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.