Active NPI
Awa Penda Jordan
- Counselor
- Springfield, MA
National Provider Identifier
1366077190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 110 Maple St
Springfield, MA 01105-1864 - Phone
- (413) 732-7419
- Fax
- (413) 781-1059
- NPI assigned
- Mar 12, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
110 Maple St
Springfield, MA 01105-1864
Mailing address
110 Maple St
Springfield, MA 01105-1864
Phone (413) 732-7419
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583971200000",
"number": "1366077190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 MAPLE ST",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011051864",
"telephone_number": "413-732-7419",
"fax_number": "413-781-1059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 MAPLE ST",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011051864",
"telephone_number": "413-732-7419",
"fax_number": "413-781-1059"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "AWA",
"middle_name": "PENDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-12",
"last_updated": "2020-03-12",
"certification_date": "2020-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.