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General NPI Number Information
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NPI Number | 1568836997
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Entity Type | Individual
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Provider Name | ROBIN L JORDAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/23/2015
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 5 MIRACLE STRIP LOOP STE 15
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City | PANAMA CITY BEACH
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State | FL
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Zip | 32407-8410
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Country | US
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Telephone | 850-235-8495
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Fax |
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Provider Business Mailing Address
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Address Line | 5 MIRACLE STRIP LOOP STE 15
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City | PANAMA CITY BEACH
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State | FL
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Zip | 32407-8410
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Country | US
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Telephone | 850-235-8495
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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 | SW22229
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License Number State | FL
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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 | 34008227A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 253255
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License Number State | KY
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