Individual provider Active NPI

Robin L Jordan, LCSW

  • Clinical Social Worker
  • Panama City Beach, FL
National Provider Identifier
1568836997
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
253255 Issued in KY
Practice address
5 Miracle Strip Loop Ste 15
Panama City Beach, FL 32407-8410
Phone
(850) 235-8495
NPI assigned
Nov 23, 2015
Last updated
Jun 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW22229 FL
Clinical Social Worker 1041C0700X 34008227A IN
Clinical Social Worker 1041C0700X 253255 KY Primary

Addresses

Primary practice location

5 Miracle Strip Loop Ste 15
Panama City Beach, FL 32407-8410

Mailing address

5 Miracle Strip Loop Ste 15
Panama City Beach, FL 32407-8410
Phone (850) 235-8495

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230216000149 KY Practitioner - Clinical Social Worker 5294107447 Reassigns benefits to 1 organization
I20250527001667 FL Practitioner - Clinical Social Worker 5294107447 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mental Awakening Counseling, LLCGroup PAC ID 4385016534, 4 clinicians

Practice addresses (Care Compare)

2950 Breckenridge LN
Suite 10a
Louisville, KY 40220-1495
Phone (502) 689-1613

5 Miracle Strip Loop
Suite 15
Panama City Beach, FL 32407-8410
Phone (850) 235-8495

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Awakening Counseling, LLC Clinical CurrentSince Dec 27, 2022 Accepting new patients

Locations

5 Miracle Strip Loop
Ste 15
Panama City Beach, FL 32407
Phone (850) 235-8495

2950 Breckenridge Ln
Ste 10A
Louisville, KY 40220
Phone (502) 451-6887

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1448236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1568836997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 MIRACLE STRIP LOOP STE 15",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324078410",
            "telephone_number": "850-235-8495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MIRACLE STRIP LOOP STE 15",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324078410",
            "telephone_number": "850-235-8495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "ROBIN",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-23",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW22229",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008227A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "253255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City Beach, FL

Sources for this page

Verify at the official NPI Registry.