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General NPI Number Information
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NPI Number | 1942857974
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Entity Type | Individual
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Provider Name | JORDAN ALLENE BERGER
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Gender | Female
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Dates
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Enumeration Date | 08/23/2019
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Last Update Date | 08/23/2019
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Provider Practice Location Address
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Address Line | 650 PENNSYLVANIA AVE SE STE 440
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City | WASHINGTON
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State | DC
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Zip | 20003-4424
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Country | US
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Telephone | 202-544-5440
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Fax |
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Provider Business Mailing Address
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Address Line | 326 15TH ST SE UNIT 1A
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City | WASHINGTON
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State | DC
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Zip | 20003-2340
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Country | US
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Telephone | 314-532-6254
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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 | LG50083046
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License Number State | DC
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