Provider Demographics
NPI:1093049769
Name:OSHER, JORDAN ELENA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JORDAN
Middle Name:ELENA
Last Name:OSHER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 W NORTH LOOP BLVD APT 208
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-2335
Mailing Address - Country:US
Mailing Address - Phone:301-922-7477
Mailing Address - Fax:
Practice Address - Street 1:2200 W NORTH LOOP BLVD APT 208
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-2335
Practice Address - Country:US
Practice Address - Phone:301-922-7477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-28
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX592251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical