Tracy Jordan, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12109 Issued in MD

Legal business name

TRACY JORDAN, LCSW-C

Practice address

9650 Santiago Rd Ste 3
Columbia, MD 21045-3960

Phone

(410) 446-5678

NPI assigned

Oct 20, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Tracy Suzanne Jordan, LCSW-C

Title

Licensed Clinical Social Worker

Phone

(410) 446-5678

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287532800000",
    "number": "1699085993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2190 OAK FOREST DR",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210431966",
            "telephone_number": "410-446-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9650 SANTIAGO RD STE 3",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210453960",
            "telephone_number": "410-446-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACY JORDAN, LCSW-C",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-20",
        "last_updated": "2010-10-20",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "SUZANNE",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "410-446-5678",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "12109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHNS HOPKINS HEALTHCARE",
            "identifier": "122305",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Columbia, MD
• Providers in Columbia, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; 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.