Individual provider Active NPI

Jennifer Leslie Jordan, LCSW-C

  • Clinical Social Worker
  • Frederick, MD
National Provider Identifier
1750424982
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10948 Issued in MD
Practice address
5229 New Design Rd
Frederick, MD 21703-7103
Phone
(301) 668-1320
Fax
(301) 696-1390
NPI assigned
Feb 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 10948 MD Primary

Addresses

Primary practice location

5229 New Design Rd
Frederick, MD 21703-7103

Mailing address

23402 Barth Spring LN
Smithsburg, MD 21783-1940
Phone (301) 824-2697

Other names 1

  • Jennifer Leslie Harvey Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20151117000892 MD Practitioner - Clinical Social Worker 4284944521 Practice locations: Hagerstown, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1185 Mount Aetna Rd
Suite 301
Hagerstown, MD 21740-6832
Phone (301) 788-0571

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10948MDMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lisa R. Halpern, MD, LLC Past Accepting new patients

Organizations & group practices 1

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": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750424982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23402 BARTH SPRING LN",
            "city": "SMITHSBURG",
            "state": "MD",
            "postal_code": "217831940",
            "telephone_number": "301-824-2697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5229 NEW DESIGN RD",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217037103",
            "telephone_number": "301-668-1320",
            "fax_number": "301-696-1390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "JENNIFER",
        "middle_name": "LESLIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "10948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HARVEY",
            "middle_name": "LESLIE",
            "credential": "LCSW-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.