Terrie L Jordan, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1601 Issued in NH

Practice address

90 Vandenberg Dr
66 MDS(Afmc) BLDG 1900
Hanscom Afb, MA 01731-2104

Phone

(781) 225-6789

Fax

(781) 225-2576

NPI assigned

Dec 15, 2005

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390348800000",
    "number": "1720064496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 VANDENBERG DR",
            "address_2": "66 MDS(AFMC) BLDG 1900",
            "city": "HANSCOM AFB",
            "state": "MA",
            "postal_code": "017312104",
            "telephone_number": "781-225-6789",
            "fax_number": "781-225-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 VANDENBERG DR",
            "address_2": "66 MDS(AFMC) BLDG 1900",
            "city": "HANSCOM AFB",
            "state": "MA",
            "postal_code": "017312104",
            "telephone_number": "781-225-6789",
            "fax_number": "781-225-2576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "TERRIE",
        "middle_name": "L",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-15",
        "last_updated": "2014-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "1601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Charles Hludzik, DMD
• Caroline Moreira Hoehene, PA-C
• Kellie Maureen Holovac, MD
• Curtis Jason Howell, APA-C
• Christopher R Jones, DDS
• Bryan Russell Katz, DDS
• Alina Cheyne Kelley, LCSW
• Ashley Kelton, M.S., CCC-SLP
• Kylee Kerns, RN
• John Ian Kesler, PHARM.D.

• All providers in Hanscom Afb, MA
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; 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.