Organization Active NPI

Jourdan Marie Porter, PSYD Med LLC

  • Clinical Psychologist
  • Philadelphia, PA
National Provider Identifier
1730988254
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
JOURDAN MARIE PORTER, PSYD MED LLC
Practice address
100 S Broad St Ste 834
Philadelphia, PA 19110-1018
Phone
(267) 692-2858
NPI assigned
Mar 8, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Authorized official

Name
Dr. Jourdan Marie Porter, PSYD MEDNPI 1497497002
Title
Licensed Clinical Psychologist
Phone
(601) 862-0343

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

100 S Broad St Ste 834
Philadelphia, PA 19110-1018

Mailing address

37 S Ruby St
Philadelphia, PA 19139-3322
Phone (601) 862-0343

Other practice location 1

37 S Ruby St
Philadelphia, PA 19139-3322
Phone (601) 862-0343

Other names 1

  • Small Spoons Healing Doing business as

National Provider Directory

National Provider Directory

Locations

100 S Broad St
Ste 834
Philadelphia, PA 19110
Phone (267) 209-3390

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1741392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754438400000",
    "number": "1730988254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 S RUBY ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191393322",
            "telephone_number": "601-862-0343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S BROAD ST STE 834",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191101018",
            "telephone_number": "267-692-2858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "37 S Ruby St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191393322",
            "country_code": "US",
            "telephone_number": "601-862-0343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JOURDAN MARIE PORTER, PSYD MED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-08",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "JOURDAN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "601-862-0343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD MED"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Small Spoons Healing",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; 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.