Jordan Ashley Dudley, LCSW-A

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P017579 Issued in NC

Practice address

2457 Gum Branch Rd Ste 800
Jacksonville, NC 28540-4008

Phone

(910) 238-2774

NPI assigned

Jun 8, 2022

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

Opted out of Medicare

Yes, effective Jun 3, 2025 through Jun 3, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/25666/brand/1/csg/1/fhir/r4

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.

• Bay Area Psychology Associates, PLLC

  • Psychologist
  • Jacksonville, NC
  • NPI 1629499819

  Clinical

  NPD

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1427787159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 HIGH STEPPER CT",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285408007",
            "telephone_number": "909-730-0997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2457 GUM BRANCH RD STE 800",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285404008",
            "telephone_number": "910-238-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "JORDAN",
        "middle_name": "ASHLEY",
        "credential": "LCSW-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-08",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P017579",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "P017579",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr. Jose I. Arauz-Dutari,DMD, PA
• Rebecca Ann Drake, LCSW
• Sharon Michele Dresbach, PH.D.
• Robert Charles Du Charme Jr., P.A.-C
• Christine Dubose
• Jessica Duehring, M.P.T.
• Samantha Dukes, LCSWA
• Ginnovia Rena Dumas
• Kelly D Duncan, CNM, FNP
• Patrick Duncan, LCSWA

• Clinical Social Worker in Jacksonville, NC
• Providers in Jacksonville, 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 Jun 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.