Provider Demographics
NPI:1033673843
Name:HILLARY, JORDYN G (MSW, LLMSW)
Entity Type:Individual
Prefix:
First Name:JORDYN
Middle Name:G
Last Name:HILLARY
Suffix:
Gender:F
Credentials:MSW, LLMSW
Other - Prefix:
Other - First Name:JORDYN
Other - Middle Name:
Other - Last Name:HILLARY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:JORDYN HILLARY LLMSW
Mailing Address - Street 1:27777 INKSTER RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-5326
Mailing Address - Country:US
Mailing Address - Phone:248-299-0030
Mailing Address - Fax:
Practice Address - Street 1:5980 S MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-2377
Practice Address - Country:US
Practice Address - Phone:248-894-1699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-25
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
MI68511140821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician