| Tracy Jordan, Lcsw-c | |
|
9650 Santiago Rd Ste 3 Columbia MD 21045-3960 | |
| (410) 446-5678 | |
| Not Available |
| Full Name | Tracy Jordan, Lcsw-c |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 9650 Santiago Rd Ste 3, Columbia, Maryland |
| Authorized Official Name and Position | Tracy Suzanne Jordan (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 4104465678 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tracy Jordan, Lcsw-c 2190 Oak Forest Dr Ellicott City MD 21043-1966 Ph: (410) 446-5678 | Tracy Jordan, Lcsw-c 9650 Santiago Rd Ste 3 Columbia MD 21045-3960 Ph: (410) 446-5678 |
| NPI Number | 1699085993 |
|---|---|
| Provider Enumeration Date | 10/20/2010 |
| Last Update Date | 10/20/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699085993 | NPI | - | NPPES |
| 122305 | Other | MD | JOHNS HOPKINS HEALTHCARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 12109 (Maryland) | Primary |
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