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General NPI Number Information
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NPI Number | 1386412591
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Entity Type | Individual
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Provider Name | JORDAN ELIZABETH BRODY MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/18/2023
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Last Update Date | 12/18/2023
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Provider Practice Location Address
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Address Line | 5301 N FEDERAL HWY STE 270
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City | BOCA RATON
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State | FL
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Zip | 33487-4910
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Country | US
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Telephone | 954-995-0404
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Fax |
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Provider Business Mailing Address
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Address Line | 1299 S OCEAN BLVD APT F11
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City | BOCA RATON
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State | FL
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Zip | 33432-7772
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Country | US
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Telephone | 412-737-2855
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 20550
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License Number State | FL
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