| Jordan Therapeutic Services Llc | |
|
3711 Delverne Rd Baltimore MD 21218-2126 | |
| (410) 979-4407 | |
| Not Available |
| Full Name | Jordan Therapeutic Services Llc |
|---|---|
| Speciality | Social Worker |
| Location | 3711 Delverne Rd, Baltimore, Maryland |
| Authorized Official Name and Position | Kimberly Jordan (SOCIAL WORKER CLINICAL) |
| Authorized Official Contact | 4109794077 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jordan Therapeutic Services Llc 3711 Delverne Rd Baltimore MD 21218-2126 Ph: (410) 979-4407 | Jordan Therapeutic Services Llc 3711 Delverne Rd Baltimore MD 21218-2126 Ph: (410) 979-4407 |
| NPI Number | 1407629322 |
|---|---|
| Provider Enumeration Date | 11/02/2023 |
| Last Update Date | 11/02/2023 |
| Certification Date | 11/02/2023 |
| Medicare PECOS PAC ID | 5890143085 |
|---|---|
| Medicare Enrollment ID | O20231129000381 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407629322 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kimberly J Jordan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285009548 PECOS PAC ID: 3577843077 Enrollment ID: I20161129000623 |
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