Healthcare Provider Details

I. General information

NPI: 1588342158
Provider Name (Legal Business Name): JORDYN N ALLEN MSW, LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2023
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17886 E 23RD ST S
INDEPENDENCE MO
64057-1840
US

IV. Provider business mailing address

21712 W 54TH ST
SHAWNEE KS
66226-9755
US

V. Phone/Fax

Practice location:
  • Phone: 816-254-3654
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2024013894
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13448
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: