Provider Demographics
NPI:1003690785
Name:GAYDEN, JORDAN DANIELE
Entity Type:Individual
Prefix:MRS
First Name:JORDAN
Middle Name:DANIELE
Last Name:GAYDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JORDAN
Other - Middle Name:DANIELE
Other - Last Name:WASHINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1801 MISSISSIPPI AVE SE
Mailing Address - Street 2:APPLE TREE @ PARKLANDS (3RD FLOOR)
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020
Mailing Address - Country:US
Mailing Address - Phone:202-488-3990
Mailing Address - Fax:
Practice Address - Street 1:1801 MISSISSIPPI AVE SE
Practice Address - Street 2:APPLE TREE @ PARKLANDS (3RD FLOOR)
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020
Practice Address - Country:US
Practice Address - Phone:202-488-3990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLG2000025581041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool