Nicole Federici Jordan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW020712 Issued in PA

Practice address

1111 E End Blvd
Wilkes Barre, PA 18711-0030

Phone

(570) 824-3521

NPI assigned

Jan 4, 2017

Last updated

Jul 13, 2022By the provider in NPPES

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1483488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1548705395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E END BLVD BLDG 3",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110030",
            "telephone_number": "570-824-3521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E END BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110030",
            "telephone_number": "570-824-3521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDERICI JORDAN",
        "first_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-04",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW130095",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW020712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Ali Fateh, D.O.
• Katrina Favata, CRS
• Elayna Marie Fazio, PA-C
• Shauna Lee Fedak, CRS
• Julie Fedder, RN
• Peter A Feinstein, MD
• Adriana Feliz, MD
• Mary Fellin, LCSW
• Kimberly Ann Ference, PHARM.D.
• Lisa Ferenchick

• Clinical Social Worker in Wilkes Barre, PA
• Providers in Wilkes Barre, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.