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NPI Code Detail

MEDICARE: MS. MILAH JORDAN LCSW

MEDICARE:  MS. MILAH  JORDAN  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLCSW25695CA

General Provider Information

NPI Number : 1366569592
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MILAH JORDAN LCSW
Provider Business Mailing Address
First Line : 3553 ATLANTIC AVE STE B130
Second Line :
City : LONG BEACH
State : CA
Zip : 90807-5606
Country : US
Telephone Number : 310-200-1810
Fax Number :
Provider Business Practice Location Address
First Line : 1450 CEDAR AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90813-1705
Country : US
Telephone Number : 310-200-1810
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2007
Last Update Date : 03/05/2024

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Directions to “ MS. MILAH JORDAN LCSW” Practice Location

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