Jordan Gulley, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC50081232 Issued in DC

Practice address

800 John Carlyle St Apt 313
Alexandria, VA 22314-6849

Phone

(804) 366-6823

NPI assigned

Dec 10, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Nov 28, 2023 through Nov 28, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1639094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1851050439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 JOHN CARLYLE ST APT 313",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223146849",
            "telephone_number": "804-366-6823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 JOHN CARLYLE ST APT 313",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223146849",
            "telephone_number": "804-366-6823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULLEY",
        "first_name": "JORDAN",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-10",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50081232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Jgulley",
            "affiliation": "N",
            "endpointDescription": "Virtual therapy",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "800 John Carlyle St Apt 313",
            "city": "Alexandria",
            "state": "VA",
            "country_code": "US",
            "postal_code": "223146849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Chelsea Guevara Perez
• Angelica Guevara-Lopez
• Elizabeth Bianca Guilford, DPT, PT
• Tersit Menberu Gulelat
• Yodit Gulelat
• Elaine Marie Gullotta, MA
• Chloe Jade A Gumataotao
• Anastasia Gunberg, PA-C
• Allison C Gunta, MS CCC SLP
• Joni Gunzburger, FNP-C

• Clinical Social Worker in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.