Active NPI
Brian Keith Jordan, LMSW
- Social Worker
- Riverhead, NY
National Provider Identifier
1689303026
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 103179
- Practice address
- 300 Center Dr FL 2
Riverhead, NY 11901-3393 - Phone
- (631) 852-2680
- NPI assigned
- Jun 9, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 103179 | NY | Primary |
Addresses
Primary practice location
300 Center Dr FL 2
Riverhead, NY 11901-3393
Mailing address
2802 Connecticut Ave
Medford, NY 11763-1913
Phone (631) 902-2481
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1053721 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786060800000",
"number": "1689303026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2802 CONNECTICUT AVE",
"city": "MEDFORD",
"state": "NY",
"postal_code": "117631913",
"telephone_number": "631-902-2481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 CENTER DR FL 2",
"city": "RIVERHEAD",
"state": "NY",
"postal_code": "119013393",
"telephone_number": "631-852-2680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "BRIAN",
"middle_name": "KEITH",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-06-09",
"last_updated": "2026-08-07",
"certification_date": "2026-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "103179",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverhead, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.