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1639658487 NPI number — JORDYN BRITTANI MORALES LCSW

NPI Number: 1639658487
Health Care Provider/Practitioner: JORDYN BRITTANI MORALES LCSW

Information about “1639658487” NPI (JORDYN BRITTANI MORALES LCSW) exists in 1639658487 in HTML format HTML  |  1639658487 in plain Text format TXT  |  1639658487 in PDF (Portable Document Format) PDF  |  1639658487 in an XML format XML  formats.

NPI Number : 1639658487 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1639658487",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MORALES",
    "FirstName": "JORDYN",
    "MiddleName": "BRITTANI",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LCSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "8383 NE SANDY BLVD STE 440",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PORTLAND",
    "MailingAddressStateName": "OR",
    "MailingAddressPostalCode": "97220-4986",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "971-373-5917",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "10615 SE CHERRY BLOSSOM DR STE 250",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PORTLAND",
    "PracticeLocationAddressStateName": "OR",
    "PracticeLocationAddressPostalCode": "97216-3103",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "971-373-4041",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/13/2018",
    "LastUpdateDate": "05/14/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1041C0700X",
        "TaxonomyName": "Clinical Social Worker",
        "LicenseNumber": "L11904",
        "LicenseNumberStateCode": "OR",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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