Active NPI
Glory Jordan, LCSW, DCSW
- Clinical Social Worker
- Bloomingdale, IL
National Provider Identifier
1811054224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.002321
- Practice address
- 1 Tiffany PT
Suite 203
Bloomingdale, IL 60108-2936 - Phone
- (630) 924-0600
- Fax
- (866) 808-2485
- NPI assigned
- Jan 3, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149.002321 | IL | Primary |
Addresses
Primary practice location
1 Tiffany PT
Suite 203
Bloomingdale, IL 60108-2936
Mailing address
1 Tiffany PT
Suite 203
Bloomingdale, IL 60108-2936
Phone (630) 924-0600
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 262945 | Other | IL | VALUE OPTIONS PROVIDER NO |
| 363716771 | Other | IL | TAX ID |
| 7435198 | Other | IL | AETNA BEHAVORIAL HEALTH |
| 363716771 0012 | Other | IL | CIGNA BEHAVORIAL HEALTH |
| 2232789 | Other | IL | BCBS PROVIDER NUMBER |
| 476392000 | Other | IL | MAGELLAN HEALTH SERVICES |
| 206554117 | Other | IL | UNITED BEH. HEALTH PROVID |
Other names 1
- Glory Friddell-Jordan
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149.002321 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396828800000",
"number": "1811054224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 TIFFANY PT",
"address_2": "SUITE 203",
"city": "BLOOMINGDALE",
"state": "IL",
"postal_code": "601082936",
"telephone_number": "630-924-0600",
"fax_number": "630-206-3019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 TIFFANY PT",
"address_2": "SUITE 203",
"city": "BLOOMINGDALE",
"state": "IL",
"postal_code": "601082936",
"telephone_number": "630-924-0600",
"fax_number": "866-808-2485"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "GLORY",
"name_prefix": "Ms.",
"credential": "LCSW, DCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-03",
"last_updated": "2014-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.002321",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS PROVIDER NO",
"identifier": "262945",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "363716771",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA BEHAVORIAL HEALTH",
"identifier": "7435198",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA BEHAVORIAL HEALTH",
"identifier": "363716771 0012",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "2232789",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN HEALTH SERVICES",
"identifier": "476392000",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEH. HEALTH PROVID",
"identifier": "206554117",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "GLORY",
"last_name": "FRIDDELL-JORDAN",
"credential": "LCSW, DCSW",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Bloomingdale, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.