Individual provider Active NPI

Michael Christopher Jordan, MSS, LCSW

  • Clinical Social Worker
  • Jenkintown, PA
National Provider Identifier
1962695338
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW015784 Issued in PA
Practice address
261 Old York Rd Ste 318
Jenkintown, PA 19046-3709
Phone
(215) 885-3337
NPI assigned
Aug 20, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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 CW015784 PA Primary

Addresses

Primary practice location

261 Old York Rd Ste 318
Jenkintown, PA 19046-3709

Mailing address

5429 Vicaris St
Philadelphia, PA 19128-2823
Phone (267) 581-1977

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20080404000160 PA Practitioner - Clinical Social Worker 6204913056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sri Psychological Services PCGroup PAC ID 1456331214, 34 clinicians

Practice addresses (Care Compare)

261 Old York Rd
Suite 318
Jenkintown, PA 19046-3709
Phone (215) 885-3337

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sri Psychological Services, PC CurrentSince Aug 1, 2023 Accepting new patients

Locations

261 Old York Rd
Ste 318
Jenkintown, PA 19046
Phone (215) 371-3490

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": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1962695338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5429 VICARIS ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191282823",
            "telephone_number": "267-581-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 OLD YORK RD STE 318",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190463709",
            "telephone_number": "215-885-3337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "MICHAEL",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Mr.",
        "credential": "MSS, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-20",
        "last_updated": "2023-06-29",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW015784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jenkintown, PA

Sources for this page

Verify at the official NPI Registry.