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General NPI Number Information
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NPI Number | 1992136246
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Entity Type | Individual
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Provider Name | TIFFANY JA'NAE JORDAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/11/2013
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 3200 SOUTHWEST FWY STE 2100
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City | HOUSTON
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State | TX
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Zip | 77027-7525
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Country | US
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Telephone | 833-208-7770
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Fax |
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Provider Business Mailing Address
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Address Line | 210 ATHENS WAY STE 240
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City | NASHVILLE
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State | TN
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Zip | 37228-1308
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Country | US
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Telephone | 833-208-7770
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Fax | 833-464-3584
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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 | 22603
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License Number State | MD
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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 | LC200003685
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License Number State | DC
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Taxonomy #3
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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 #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 112068
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License Number State | TX
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