Menyuan Jordan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW007869 Issued in GA

Practice address

107 Enterprise Path Ste 300
Hiram, GA 30141-2690

Phone

(678) 588-7982

NPI assigned

Dec 29, 2021

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

Enrolled in GA

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 1

Specialty

Clinical Social Worker

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  GA

  Medicare reassignment Care Compare group NPD
• Highland Rivers Community Service Board

  • Community/Behavioral Health Agency
  • Dalton, GA
  • NPI 1447256243
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, GA

  Medicare reassignment NPD
• Olive Tree Therapy & Wellness, LLC

  • Adult Mental Health Clinic/Center
  • Hiram, GA
  • NPI 1558127365
  NPD Authorized official
• The Northrop Connection, LLC

  • Clinical Social Worker
  • Dallas, GA
  • NPI 1912398868
  Medicare reassignment
• Highland Rivers CSB

  • Community/Behavioral Health Agency
  • Dalton, GA
  • NPI 1164585543
  NPD
• Highland Rivers CSB

  • Community/Behavioral Health Agency
  • Hiram, GA
  • NPI 1578626917
  NPD (past)

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

{
    "created_epoch": "1640736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1639839863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 ENTERPRISE PATH STE 300",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301412690",
            "telephone_number": "678-588-7982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 ENTERPRISE PATH STE 300",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301412690",
            "telephone_number": "678-588-7982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "MENYUAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-29",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW007869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claude Johnson Jr., OTA/CLT
• Kanisha Johnson, BSN RN
• Kimberly Johnson, LPC
• Kwana Jones
• Clevevoya Daletrease Jordan, LPC, NCC
• Kaday Kabba-Howard, LPC
• Aimee Johnson Kaltenbach, AUD
• Deborah R Karp, MD
• Grace Keely, LPC
• Aron Ethiopia Kefela, MD

• Clinical Social Worker in Hiram, GA
• Providers in Hiram, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.