Jordan Therapeutic Services LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

JORDAN THERAPEUTIC SERVICES LLC

Practice address

3711 Delverne Rd
Baltimore, MD 21218-2126

Phone

(410) 979-4407

NPI assigned

Nov 2, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kimberly Jordan, LCSW-CNPI 1285009548

Title

Social Worker Clinical

Phone

(410) 979-4077

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberly Jordan, LCSW-C

  • Clinical Social Worker
  • Baltimore, MD
  • NPI 1285009548
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1698883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698883200000",
    "number": "1407629322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3711 DELVERNE RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212182126",
            "telephone_number": "410-979-4407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3711 DELVERNE RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212182126",
            "telephone_number": "410-979-4407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JORDAN THERAPEUTIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-02",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "SOCIAL WORKER CLINICAL",
        "authorized_official_telephone_number": "410-979-4077",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Henry Hyonoo Joo
• Angelita A Jopacio, MD
• Jeffrey Kyle Jopling, M.D.
• Joppa Road Pharmacy LLC
• Nyjze Alexicia Joppy
• Gayle Jordan-Randolph, M.D.
• Arianna Yoshiko Jordan, OD
• Ayana Jordan, RN
• Beth Jordan, MD
• Brenda Jordan, M.D.

• Clinical Social Worker in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.