Jordan Mikala Everett, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-4333 Issued in HI

Practice address

91-2301 Old Ft Weaver Rd
Ewa Beach, HI 96706-3602

Phone

(808) 671-8511

NPI assigned

Aug 18, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Queens University Medical Group

  • Multi-Specialty Clinic/Center
  • Honolulu, HI
  • NPI 1891441382
  NPD

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

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1609242213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-975 WAIHUA PL",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967061867",
            "telephone_number": "808-419-4619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-2301 OLD FT WEAVER RD",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967063602",
            "telephone_number": "808-671-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERETT",
        "first_name": "JORDAN",
        "middle_name": "MIKALA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-18",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "LCSW-4333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yanisa Thong Empleo
• Chaelyn Enos
• Chelsey Osorio Santos Erece
• Aileen A Esmeralda, MS COUNSELING PSYCH
• Maylenne Eugenio
• Ewa Beach Dentists LLC (Hawaii Dental Clinic Ewa Beach)
• Ewa Beach Physical Therapy LLC (Westside Physical Therapy)
• Ewa Beach Physical Therapy LLC
• Ewa Emergency Group LLC
• Executives Group Dba Divine Touch Home Care Sevices

• Clinical Social Worker in Ewa Beach, HI
• Providers in Ewa Beach, HI by specialty
• Clinical Social Worker in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.