Shauntai Nicole Jordan, LCSW, MS

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW10639 Issued in FL

Practice address

2181 East Orange Avenue
Tallahassee, FL 32311

Phone

(850) 513-7830

NPI assigned

Nov 20, 2009

Sex

Female

Sole proprietor

Yes

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1258675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1538497078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2181 EAST ORANGE AVE",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323116144",
            "telephone_number": "850-513-7830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2181 EAST ORANGE AVENUE",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "32311",
            "telephone_number": "850-513-7830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "SHAUNTAI",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-20",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW10639",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "ISW 5381",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William H Jones Jr.
• Willishea Lanae Jones, PHARM.D.
• Adam Chong Joo, M.D.
• Crystal D Jordan, APRN
• Jiterience Jordan, DC
• Tynesha Monique Jordan
• Jorge K. Gorb, O.D.
• Joseph D. Miller, DC, PA
• Joseph L. Webster Sr. MD. PA
• Santia Joseph-Fertil

• Clinical Social Worker in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; 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.