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General NPI Number Information
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NPI Number | 1023861424
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Entity Type | Individual
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Provider Name | JORDAN GALLOWAY
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Gender | Female
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Dates
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Enumeration Date | 04/08/2024
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 1200 MURCHISON RD
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City | FAYETTEVILLE
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State | NC
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Zip | 28301-4252
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Country | US
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Telephone | 910-672-1446
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Fax |
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Provider Business Mailing Address
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Address Line | 710 CL TART CIR APT 203
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City | FAYETTEVILLE
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State | NC
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Zip | 28314-3115
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Country | US
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Telephone | 336-471-2222
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCAS-30352
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P020326
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License Number State | NC
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