Individual provider Active NPI

Tiffany Ja'Nae Jordan, LCSW

  • Clinical Social Worker
  • Houston, TX
National Provider Identifier
1992136246
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
112068 Issued in TX
Practice address
3200 Southwest Fwy Ste 2100
Houston, TX 77027-7525
Phone
(833) 208-7770
NPI assigned
Dec 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 22603 MD
Clinical Social Worker 1041C0700X LC200003685 DC
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 112068 TX Primary

Addresses

Primary practice location

3200 Southwest Fwy Ste 2100
Houston, TX 77027-7525

Mailing address

210 Athens Way Ste 240
Nashville, TN 37228-1308
Phone (833) 208-7770

Other identifiers 1

IdentifierTypeStateIssuer
1992136246MedicaidTX

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

LicenseStateTypeSpecialty
LC200003685DCMDClinical Social Worker
112068TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aspire Health Partners, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tiffany.jordan.1@27760.direct.athenahealth.com

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": "1386720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1992136246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 ATHENS WAY STE 240",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372281308",
            "telephone_number": "833-208-7770",
            "fax_number": "833-464-3584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 SOUTHWEST FWY STE 2100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770277525",
            "telephone_number": "833-208-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "TIFFANY",
        "middle_name": "JA'NAE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-11",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "22603",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC200003685",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "112068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992136246",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.