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General NPI Number Information
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NPI Number | 1841842143
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Entity Type | Individual
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Provider Name | DANIELLE JORDAN LMSW
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Gender | Female
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Dates
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Enumeration Date | 07/16/2019
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Last Update Date | 09/13/2019
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Provider Practice Location Address
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Address Line | 444 2ND AVE APT 25E
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City | NEW YORK
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State | NY
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Zip | 10010-2522
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Country | US
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Telephone | 917-414-4067
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Fax |
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Provider Business Mailing Address
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Address Line | 444 2ND AVE APT 25E
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City | NEW YORK
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State | NY
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Zip | 10010-2522
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Country | US
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Telephone | 917-414-4067
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 107357
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License Number State | NY
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