Individual provider Active NPI

Amy B Jordan, LCSW

  • Clinical Social Worker
  • Austin, TX
National Provider Identifier
1750166450
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
104666 Issued in TX
Practice address
9911 Woodland Village Dr Ste B
Austin, TX 78750-3362
Phone
(512) 487-4410
NPI assigned
Aug 30, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 104666 TX
Clinical Social Worker 1041C0700X 104666 TX Primary

Addresses

Primary practice location

9911 Woodland Village Dr Ste B
Austin, TX 78750-3362

Mailing address

12805 Council Bluff Dr
Austin, TX 78727-2618
Phone (512) 680-1867

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20250117001076 TX Practitioner - Clinical Social Worker 2860921954 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
104666TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
My-Emerge PLLC Clinical CurrentSince Nov 16, 2024 Accepting new patients
Resilience Retreat Therapy PLLC PastSince Jul 20, 2026 Accepting new patients

Locations

12343 Hymeadow Dr
Ste 3E
Austin, TX 78750
Phone (512) 861-4154

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1693353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1750166450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12805 COUNCIL BLUFF DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787272618",
            "telephone_number": "512-680-1867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9911 WOODLAND VILLAGE DR STE B",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787503362",
            "telephone_number": "512-487-4410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "AMY",
        "middle_name": "B",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-30",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "104666",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "104666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.