Healthcare Provider Details

I. General information

NPI: 1063343994
Provider Name (Legal Business Name): JORDAN PAIGE SANDERS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 TENNESSEE RD STE J
ALBANY KY
42602-1074
US

IV. Provider business mailing address

1471 CEDAR HILL RD
ALBANY KY
42602-8621
US

V. Phone/Fax

Practice location:
  • Phone: 606-688-2071
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW00001129
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: