Roberta Ellen Jordan
Individual provider Active NPI Clinical Social Worker · West Yarmouth, MA
NPI 1962986869 · NPPES record last updated Sep 18, 2018
Key facts
- NPI
- 1962986869
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 118300 (MA)
- Practice address
- 579 Buck Island Rd
West Yarmouth, MA 02673-3200 - Phone
- (508) 957-7007
- Fax
- (508) 790-8116
- NPI assigned
- Sep 18, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 118300 | MA | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 118300 | MA | Yes |
Addresses
Primary practice location
579 Buck Island Rd
West Yarmouth, MA 02673-3200
Mailing address
Maplewood Mayflower Place SNF, LLC
579 Buck Island Road
West Yarmouth, MA 02673
Phone (508) 957-7007
Other providers in West Yarmouth, MA
- Evan Daniel Healy
- Sandra Hebenstreit
- Hri Clinics, Inc.
- Hyannis Animal Hospital, Inc
- John C. Serijan, D.M.D., P.C.
- Doris Clawson Kapp
- Stephen Shaun Katzenback
- Anne Lauren Koch
- Laura K Kondrat
- Lauren Krystopolski
All providers in West Yarmouth, MA · Clinical Social Worker in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 18, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.